ICD-10 code changes in the 2019 Myalgia series that will greatly impact chiropractors and their billing staff.

Chiropractors and their billing staff are all abuzz about the 2019 ICD-10 codes. We’ve been receiving lots of questions regarding the specific code changes, and the date that they go into effect. For clarification, while the newest code is named ICD-10 2019, the codes actually went into effect on October 1, 2018.

The good news is that the list of code changes aren’t as extensive as in years before. We will be addressing more of those changes in future posts, but for now, let’s focus on code changes in the Myalgia series, which will have a significant impact on chiropractors and billers.

Myalgia Codes

Before recent code changes, ICD-10 M79.1 covered any type of Myalgia, regardless of location. This code is no longer a billable and payable code.

The ICD-10-CM manual for 2019

The ICD-10-CM manual for 2019 will now include the following codes instead, which provide greater specificity:

  • M79.10 — Myalgia, unspecified site
  • M79.11 — Myalgia of mastication muscle
  • M79.12 — Myalgia of auxiliary muscles, head and neck
  • M79.18 — Myalgia, other site

When choosing the correct diagnosis code, providers should be as specific as possible. Moving forward, you must avoid using the “unspecified” code even though it will remain an option in your software for claims with date of service prior to October 1, 2019.

This leaves you vulnerable to payers who will question the location of your patient’s myalgia. The most common code chiropractors will use is M79.12, which identifies and involves the muscle of the neck and head.

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In addition, remember that there are other 2019 ICD-10 codes that may more accurately describe other conditions similar to Myalgia. For instance:

  • Fibromyalgia is still a valid code at M79.7
  • The Myositis series (M60.0-M60.9) are separate and distinct from Myalgia.
  • Using either of these other codes are both still an option, but they should not be used in conjunction with Myalgia.

Have Questions?

We know that chiropractic coding and billing can be complicated. We are happy to discuss any questions you have regarding the discontinued 2019 ICD-10 codes. Just give us a call to request a free billing analysis. We look forward to hearing from you.

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