M79.7 — Fibromyalgia
M79.7 is a billable, specific ICD-10-CM code for fibromyalgia. It is valid for submission on a claim.
Inclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Fibromyositis
- Fibrositis
- Myofibrositis
Other codes that can never be billed with M79.7
These codes carry an Excludes1 note pointing at M79.7. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading M79.7 alone.
Risk adjustment
M79.7 does not map to an HCC and does not risk-adjust under CMS-HCC V28. That is normal — most ICD-10 codes do not. It still needs to be coded correctly; it just will not move a RAF score.
Medicare coverage
M79.7 is named in 36 Medicare coverage policies — 25 listing it as supporting medical necessity, and 11 listing it as NOT covered. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A57701Billing and Coding: Trigger Point Injections (TPI)not covered
- A58865Billing and Coding: Amniotic and Placental-Derived Product Injections and/or Applications for Musculoskeletal Indications, Non-Woundnot covered
- A58893Billing and Coding: Amniotic and Placental-Derived Product Injections and/or Applications for Musculoskeletal Indications, Non-Woundnot covered
- A59374Billing and Coding: Amniotic and Placental-Derived Product Injections and/or Applications for Musculoskeletal Indications, Non-Woundnot covered
How M79.7 is indexed
Coders do not find codes by browsing the tabular list — they look them up in the alphabetic index, under the word the physician wrote. These are the index entries that lead here, so you can see which chart wordings map to M79.7.
- Fibromyalgia
- Fibromyositis
- Fibrositis(periarticular)
- Myofibrositis
Related codes at this level
Codes that share M79. If M79.7 is not quite right, the correct code is usually one of these.
- M79.0Rheumatism, unspecified
- M79.1Myalgia
- M79.2Neuralgia and neuritis, unspecified
- M79.3Panniculitis, unspecified
- M79.4Hypertrophy of (infrapatellar) fat pad
- M79.5Residual foreign body in soft tissue
- M79.6Pain in limb, hand, foot, fingers and toes
- M79.ANontraumatic compartment syndrome
- M79.8Other specified soft tissue disorders
- M79.9Soft tissue disorder, unspecified
Questions about M79.7
- Is M79.7 a billable ICD-10-CM code?
- Yes. M79.7 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does M79.7 sit in the tabular list?
- Diseases of the musculoskeletal system and connective tissue (M00-M99), in the block Other soft tissue disorders (M70-M79).