2021 ICD-10-CM Code M35.3
Polymyalgia rheumatica
Valid for Submission
M35.3 is a billable diagnosis code used to specify a medical diagnosis of polymyalgia rheumatica. The code M35.3 is valid during the fiscal year 2021 from October 01, 2020 through September 30, 2021 for the submission of HIPAA-covered transactions.
The ICD-10-CM code M35.3 might also be used to specify conditions or terms like polymyalgia or polymyalgia rheumatica.
Code Classification
Tabular List of Diseases and Injuries
The Tabular List of Diseases and Injuries is a list of ICD-10 codes, organized "head to toe" into chapters and sections with guidance for inclusions, exclusions, descriptions and more. The following references are applicable to the code M35.3:
Type 1 Excludes
Type 1 ExcludesA type 1 excludes note is a pure excludes note. It means "NOT CODED HERE!" An Excludes1 note indicates that the code excluded should never be used at the same time as the code above the Excludes1 note. An Excludes1 is used when two conditions cannot occur together, such as a congenital form versus an acquired form of the same condition.
- polymyalgia rheumatica with giant cell arteritis M31.5
Index to Diseases and Injuries
The Index to Diseases and Injuries is an alphabetical listing of medical terms, with each term mapped to one or more ICD-10 code(s). The following references for the code M35.3 are found in the index:
- - Disease, diseased - See Also: Syndrome;
- - Polymyalgia - M35.3
- - rheumatica - M35.3
- - Pseudopolyarthritis, rhizomelic - M35.3
Approximate Synonyms
The following clinical terms are approximate synonyms or lay terms that might be used to identify the correct diagnosis code:
- Polymyalgia
- Polymyalgia rheumatica
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.
Diagnostic Related Groups - MS-DRG Mapping
The ICD-10 code M35.3 is grouped in the following groups for version MS-DRG V38.0 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 10/01/2020 through 09/30/2021.
Convert M35.3 to ICD-9 Code
- 725 - Polymyalgia rheumatica
Information for Patients
Polymyalgia Rheumatica
Polymyalgia rheumatica is a disorder that causes muscle pain and stiffness in your neck, shoulders, and hips. It is most common in women and almost always occurs in people over 50. The main symptom is stiffness after resting. Other symptoms include fever, weakness and weight loss. In some cases, polymyalgia rheumatica develops overnight. In others, it is gradual.
The cause is not known. There is no single test to diagnose polymyalgia rheumatica. Your doctor will use your medical history, symptoms, and a physical exam to make the diagnosis. Lab tests for inflammation may help confirm the diagnosis.
Polymyalgia rheumatica sometimes occurs along with giant cell arteritis, a condition that causes swelling of the arteries in your head. Symptoms include headaches and blurred vision. Doctors often prescribe prednisone, a steroid medicine, for both conditions. With treatment, polymyalgia rheumatica usually disappears in a day or two. Without treatment, it usually goes away after a year or more.
NIH: National Institute of Arthritis and Musculoskeletal and Skin Diseases
- ESR (Medical Encyclopedia)
- Polymyalgia rheumatica (Medical Encyclopedia)
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Code History
- 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)