M31.5 - Giant cell arteritis with polymyalgia rheumatica

Approximate Synonyms

The following clinical terms are approximate synonyms or lay terms that might be used to identify the correct diagnosis code:

• Giant cell arteritis with polymyalgia rheumatica
• Polymyalgia rheumatica
• Temporal arteritis

Clinical Information

• Polymyalgia Rheumatica-. a syndrome in the elderly characterized by proximal joint and muscle pain, high erythrocyte sedimentation rate, and a self-limiting course. pain is usually accompanied by evidence of an inflammatory reaction. women are affected twice as commonly as men and caucasians more frequently than other groups. the condition is frequently associated with giant cell arteritis and some theories pose the possibility that the two diseases arise from a single etiology or even that they are the same entity.
• Giant Cell Arteritis-. a systemic autoimmune disorder that typically affects medium and large arteries, usually leading to occlusive granulomatous vasculitis with transmural infiltrate containing multinucleated giant cells. the temporal artery is commonly involved. this disorder appears primarily in people over the age of 50. symptoms include fever; fatigue; headache; visual impairment; pain in the jaw and tongue; and aggravation of pain by cold temperatures. (from adams et al., principles of neurology, 6th ed)
• Polymyalgia Rheumatica-. a syndrome characterized by pain, stiffness, and tenderness of the proximal muscle groups including the shoulder, pelvic girdle and the neck. there is no muscle atrophy and muscle biopsies do not reveal pathologic changes. additional signs and symptoms include low grade fever, fatigue and depression.

Diagnostic Related Groups - MS-DRG Mapping

The is diagnosis code is grouped in the following groups for version MS-DRG V40.0 What are Diagnostic Related Groups?
The Diagnostic Related Groups (DRGs) are a patient classification scheme which provides a means of relating the type of patients a hospital treats. The DRGs divides all possible principal diagnoses into mutually exclusive principal diagnosis areas referred to as Major Diagnostic Categories (MDC). applicable from 10/01/2022 through 09/30/2023.

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Patient Education

Giant Cell Arteritis

Giant cell arteritis is a disorder that causes inflammation of your arteries, usually in the scalp, neck, and arms. It narrows the arteries, which keeps blood from flowing well. Giant cell arteritis often occurs with another disorder called polymyalgia rheumatica. Both are more common in women than in men. They almost always affect people over the age of 50.

Early symptoms of giant cell arteritis resemble the flu: fatigue, loss of appetite, and fever. Other symptoms include:

• Headaches
• Pain and tenderness over the temples
• Double vision or visual loss, dizziness
• Problems with coordination and balance
• Pain in your jaw and tongue

Your doctor will make the diagnosis based on your medical history, symptoms, and a physical exam. There is no specific test for giant cell arteritis, but you may have tests that measure inflammation.

Treatment is usually with corticosteroids. Early treatment is important; otherwise there is a risk of permanent vision loss or stroke. However, when properly treated, giant cell arteritis rarely comes back.

NIH: National Institute of Arthritis and Musculoskeletal and Skin Diseases

Polymyalgia Rheumatica and Giant Cell Arteritis

Code History

• FY 2023 - No Change, effective from 10/1/2022 through 9/30/2023
• FY 2022 - No Change, effective from 10/1/2021 through 9/30/2022
• FY 2021 - No Change, effective from 10/1/2020 through 9/30/2021
• FY 2020 - No Change, effective from 10/1/2019 through 9/30/2020
• FY 2019 - No Change, effective from 10/1/2018 through 9/30/2019
• FY 2018 - No Change, effective from 10/1/2017 through 9/30/2018
• FY 2017 - No Change, effective from 10/1/2016 through 9/30/2017
• FY 2016 - New Code, effective from 10/1/2015 through 9/30/2016 (First year ICD-10-CM implemented into the HIPAA code set)