What is the ICD-10 code for giant cell arteritis?

The ICD-10 code for giant cell arteritis without polymyalgia rheumatica is M31.6, while M31.5 is used when polymyalgia rheumatica is present.

How do you code giant cell arteritis with polymyalgia rheumatica?

Use ICD-10 code M31.5 for giant cell arteritis with documented polymyalgia rheumatica symptoms.

ICD-10 Coding for Giant Cell Arteritis(M31.6, H53.9, M31.5)

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Explore detailed ICD-10 coding guidelines for giant cell arteritis, including documentation requirements and common coding pitfalls.

Also known as:

Temporal ArteritisCranial Arteritis

Related ICD-10 Code Ranges

Complete code families applicable to Giant Cell Arteritis

M00-M99Primary Range

Diseases of the musculoskeletal system and connective tissue

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Code Comparison: When to Use Each Code

Compare key differences between these codes to ensure accurate selection

Code	Description	When to Use	Key Documentation
M31.6	Other giant cell arteritis	Use when giant cell arteritis is diagnosed without polymyalgia rheumatica.	Age ≥50 years Cranial symptoms such as headache or jaw claudication Elevated ESR ≥50 mm/hr or CRP ≥10 mg/dL + 1 more
M31.5	Giant cell arteritis with polymyalgia rheumatica	Use when both giant cell arteritis and polymyalgia rheumatica are documented.	Documentation of both GCA and PMR symptoms Elevated ESR or CRP Biopsy or imaging evidence

Primary ICD-10-CM Codes

Other giant cell arteritis

M31.6Billable

Differential Codes

Alternative codes to consider when ruling out similar conditions

Giant cell arteritis with polymyalgia rheumaticaM31.5

Use when both GCA and PMR are documented.

Other giant cell arteritisM31.6

Use when PMR is not present.

Documentation & Coding Risks

Avoid these common issues when documenting Giant Cell Arteritis.

Omitting biopsy results in documentation

Impact

Clinical: May lead to misdiagnosis or inappropriate treatment., Regulatory: Non-compliance with documentation standards., Financial: Potential claim denials or reduced reimbursement.

Mitigation

Ensure biopsy results are included in the patient's record., Verify documentation completeness before coding.

Coding M31.5 without PMR documentation

Impact

Reimbursement: Incorrect coding may lead to claim denials or reduced reimbursement., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data representation.

Mitigation

Ensure PMR symptoms are documented before using M31.5.

Documentation Completeness

Impact

Incomplete documentation of symptoms and lab results.

Mitigation

Implement thorough documentation practices and regular audits.

Frequently Asked Questions

Documentation requirements, coding pitfalls and FAQs for conditions coded with M31.6.

Primary Code

M31.6

Other giant cell arteritis

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ICD-10 codes5

Coding risks3

FAQs2

ICD-10 Coding for Giant Cell Arteritis(M31.6, H53.9, M31.5)

Documentation & Coding Risks

Frequently Asked Questions

What is the ICD-10 code for giant cell arteritis?

How do you code giant cell arteritis with polymyalgia rheumatica?

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