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ICD 10 Fibromyalgia: The Right Code for Your Disease

A doctor and a patient discussing

Living with fibromyalgia can be more than just physically painful.

Yes, fibromyalgia sufferers will most likely share many of the same painful symptoms, from muscle pain and soft tissue disorders to joint pain and other general symptoms that cause their bodies to stay in a state of chronic discomfort throughout the day and well into their nights.

But fibromyalgia brings on a whole host of emotional pain as well, particularly for the people who can’t seem to find the appropriate healthcare providers to diagnose their disease correctly.

There is no cure for fibromyalgia. But…there are treatment options, especially for those patients who can get the appropriate diagnosis and coding needed for help to come their way.

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What is Fibromyalgia?

In order to get the appropriate diagnosis, it will help if you understand exactly what symptoms constitute a fibromyalgia diagnosis in the first place.

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According to the Mayo Clinic‘s most recently updated definition, fibromyalgia is a musculoskeletal system disorder that presents in a way that is most similar to rheumatoid arthritis, though both have some very different characteristics as well.

Fibromyalgia leaves its victims with unexplained widespread pain, focal muscle tenderness, sleep disturbances, constant fatigue, memory loss (fibro fog), mood issues, and occasionally depression that doesn’t seem to be related to any other factor in the fibromyalgia person’s life.

Researchers believe that fibromyalgia is capable of amplifying a person’s painful sensations by affecting the way their brain and spinal cord are able to process painful and nonpainful signals.

A woman experiencing pain

Symptoms often begin after an event, such as physical trauma, surgery, infection, or significant psychological stress. In other cases, symptoms gradually accumulate over time with no single triggering event.

How Does a Person Develop Fibromyalgia?

Though there is still significant research that must be done on this disease, some studies have suggested that the signs of fibromyalgia often begin after a person has suffered a notably traumatic event, such as a physical trauma, a serious infection, a surgery, or even some sort of intense psychological stress.

In cases like these, a patient has been able to trace the beginnings of their fibromyalgia symptoms back to a time the was shortly after such an event took place.

A woman sleeping on the bed

Other patients, however, have struggled to be able to pinpoint a single, triggering event that caused the onset of their pain.

They state that certain symptoms – painful trigger points, sudden sleep problems, and unexplained muscle pain – all began gradually and continued to worsen and accumulate over time with no specific event that exacerbated them.

In either case, it’s clear that we need much more research to be dedicated to this debilitating disease for the more than 3 million people who are diagnosed with it in the United States alone every year.

Understanding How ICD Diagnosis Codes Work

Throughout the world, there is a standard set of codes that are used when billing for various ailments and diseases.

These ICD diagnosis codes are recognized worldwide and are used in hospitals, emergency rooms, clinics, and in urgent care, and doctor’s offices everywhere.

Referred to as the International Classification of Disease (ICD) codes, these are numerical identifiers that are used to classify diseases and many other health-related illnesses and problems.

Not only do these codes allow physicians and other medical professionals to be able to communicate effectively with one another and their patients when issuing a diagnosis of a disease or chronic condition, but they are also used by health insurance companies to be able to bill for services appropriately.

A woman doing research, reading from a book with laptop in her front

Until very recently, there was no ICD 10 diagnosis code for people suffering from fibromyalgia symptoms.

Remember, fibromyalgia has no cure, and there has not been significant research done on this musculoskeletal system disorder.

Because of this, the last set of ICD codes – ICD 9 – had not had a set code specifically for identifying and diagnosing fibromyalgia.

 

This was problematic for a number of reasons.

For example, take chronic fatigue syndrome. This is a complicated disorder that is usually characterized by extreme fatigue that lasts for several months with no relief, even after enough rest is received.

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On top of that, chronic fatigue syndrome can’t be fully explained by an underlying medical condition.

Though many of the symptoms of chronic fatigue syndrome look similar to those symptoms that are characteristic of fibromyalgia, it’s important to know that these are two different diseases, both with different treatment plans and outcomes.

Up until fibromyalgia had its own ICD diagnosis code, it was common for physicians and other healthcare professionals to put both these conditions into a similar diagnostic related group.

With the new ICD 10 codes, however, fibromyalgia is seen as its own, separate disease and can now be treated as such.

Now that so much of this has changed for the better, patients can feel confident in approaching their healthcare providers and medical professionals equipped with the knowledge that an ICD 10 diagnosis code now exists for their specific and chronic disorder known to all those who live with it as fibromyalgia.

Understanding the ICD 10 Diagnosis Code for Fibromyalgia

As stated earlier, each diagnosis that a physician or other medical professional makes will be given a specific diagnosis code.

According to the new ICD 10 diagnostic code handbook which became effective in October of 2022, the correct ICD 10 diagnosis code for fibromyalgia is M79.7.

The explanation for how to use this code is extensive, but the basic language states this:

A woman reading a book while lying on a couch

“Fibromyalgia is a chronic musculoskeletal system disorder of unknown etiology characterized by pain, stiffness, and tenderness in the muscles of neck, shoulders, back, hips, arms, and legs.

Other signs and symptoms include headaches, fatigue, and sleep disturbances, and can be typically aggravated by painful menstruation. Fibromyalgia is a common nonarticular rheumatic syndrome that is characterized by muscle pain, tenderness, stiffness, and other soft tissue disorders.”

How Can I Convince My Physician to Diagnose My Fibromyalgia?

Even though there is now, more than ever before, specific guidelines on how to diagnose and treat fibromyalgia, it can be incredibly challenging and frustrating for a person suffering with this disease to get the help they need.

Oftentimes, doctors still don’t get it. Even after physically examining you and taking your medical history, many physicians will still struggle to understand the varying symptoms of the disease and how they are all interconnected with one another.

A patient having a discussion with her doctor

Most patients who have tried to explain their symptoms to a physician have often had multiple points in their conversation where they wanted to just give up, convinced that no one was ever going to take their pain, their fatigue, and their constant emotional distress seriously.

But not that the world has finally recognized the validity of fibromyalgia by issuing the disease a specific ICD diagnosis code, hopefully, more doctors will begin to see the validity of this disease and understand the overwhelming discomfort so many fibromyalgia patients must suffer with on a daily basis.

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Where to Turn for More Fibromyalgia Help

If you are looking for more answers to your questions regarding fibromyalgia and need more help getting the appropriate diagnosis, Native Formula can help.

From customer testimonials to suggested action plans, Native Formula has a host of highly tested and reputable resources and tools at your disposal.

Until a test is discovered, one option patients have is to ask their physician to test them for other diseases that present in similar manners to fibromyalgia.

Because of the nature of this disease, sometimes a person may be misdiagnosed as having a similar condition, such as rheumatoid arthritis or other musculoskeletal system diseases.

Especially if you’ve had a family history of any of these other diseases, you have higher risk factors for one of them to present in your own blood work or another diagnostic test.

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