Eli's Rehab Report

Question: Our practice often treats myofascial pain syndrome, which we code as ICD-9 729.1 (Myalgia and myositis, unspecified). Is this code also appropriate when the physiatrist writes the diagnosis as "nonmalignant pain syndrome," "cervicothoracic myofascial pain syndrome" or "lumbosacral myofascial pain syndrome"?

Illinois Subscriber

Answer: Nonmalignant pain syndrome is different from unspecified myalgia and myositis. Therefore, you should code it according to the symptoms present. For instance, if the patient's nonmalignant pain roots in her lower back, code the visit using 724.2 (Lumbago).

Because the physiatrist referred to the cervicothoracic problem as a type of myofascial pain syndrome, you should offer the insurer a complete picture of the problem by pairing the myalgia and myositis code (729.1) with the cervical syndrome code (723.8) or the thoracic spine pain code (724.1).

Code the lumbosacral myofascial pain syndrome by pairing 729.1 with either 724.2 or 724.6 (Disorders of sacrum).