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Chronic Migraines r/t Fibromyalgia (Coding)

  1. Default Chronic Migraines r/t Fibromyalgia (Coding)
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    Provider diagnosed in Assessment Chronic Migraines r/t Fibromyalgia and was supported throughout the chart as Chronic Migraines and Headaches r/t Fibromyalgia. Would you code Chronic Migraines and Fibromyalgia or just Fibromyalgia?

  2. #2
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    Fibromyalgia is defined as a condition that affects the muscles and soft tissues characterized by diffuse muscle aches and pains with areas of excessive tenderness, called trigger points, accompanied by fatigue, sleep disorders, and memory and mood problems. Symptoms include pain affecting both sides of the body above and below the waist lasting for 3 months or longer; fatigue despite sleeping for long periods; and concentration difficulties.

    Since chronic migraines is not typically associated with the definition and symptoms I would code the migraines in addition to the fibro. Often times the two diagnosis are reported by a patient but it is not inherently included with fibromyalgia.
    Chelle Johnson, CPC CPMA CDEO CEMC CPCO CPPM AAPC Fellow
    Billing/Coding/Credentialing/Auditing Coordinator

    20+ years experience in Medical Billing and Auditing

  3. Default
    I'd agree. If there was tension headaches or less specific documentation, you'd just code M79.7. You do need a chronic migraine code. Its weird because the symptoms do overlap a bit... like if it was cervicogenic type headaches (which can mimic migraines)... that could be considered inherent of fibromyalgia...even if there was contributing spondylosis...unless there was something else going on in the neck. This is actually sparking debate in the neurology world, so we aren't alone in this.



    Quote Originally Posted by saraiba View Post
    Provider diagnosed in Assessment Chronic Migraines r/t Fibromyalgia and was supported throughout the chart as Chronic Migraines and Headaches r/t Fibromyalgia. Would you code Chronic Migraines and Fibromyalgia or just Fibromyalgia?

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