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v1.0.0
ICD-10 Guide
ICD-10 CodesB33.0

B33.0

Epidemic myalgia

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/05/2025

Code Description

ICD-10 B33.0 is a billable code used to indicate a diagnosis of epidemic myalgia.

Key Diagnostic Point:

Epidemic myalgia is a viral infection characterized by widespread muscle pain and discomfort, often occurring in outbreaks. It is primarily associated with viral infections such as the Coxsackie virus, which is part of the enterovirus family. Patients typically present with symptoms including fever, malaise, and significant muscle soreness, which can be debilitating. The condition is often self-limiting, but the severity of symptoms can lead to significant morbidity. Diagnosis is primarily clinical, based on patient history and symptomatology, although laboratory tests may be conducted to rule out other viral infections. Antiviral treatments are not typically required, as the condition usually resolves on its own; however, symptomatic relief can be provided through analgesics and anti-inflammatory medications. Understanding the epidemiology of the virus and the populations affected is crucial for effective management and prevention strategies.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in symptom presentation among patients
  • Overlap with other viral myalgias and conditions
  • Need for thorough patient history to rule out differential diagnoses
  • Potential for misdiagnosis due to similar symptoms with other infections

Audit Risk Factors

  • Inadequate documentation of symptom severity
  • Failure to document the outbreak context
  • Misclassification of the viral infection type
  • Lack of follow-up documentation

Specialty Focus

Medical Specialties

Infectious Disease

Documentation Requirements

Detailed patient history, symptom description, and laboratory test results.

Common Clinical Scenarios

Outbreak investigations, management of symptomatic patients, and differential diagnosis of viral infections.

Billing Considerations

Consideration of patient demographics and epidemiological data is crucial for accurate coding.

Primary Care

Documentation Requirements

Comprehensive documentation of patient symptoms, duration, and any treatments provided.

Common Clinical Scenarios

Initial patient presentations with muscle pain and fever, management of mild cases, and referrals to specialists.

Billing Considerations

Documentation should clearly indicate the clinical context and any relevant exposure history.

Coding Guidelines

Inclusion Criteria

Use B33.0 When
  • According to ICD
  • 10 coding guidelines, B33
  • 0 should be used when the condition is confirmed as epidemic myalgia due to a viral infection
  • It is important to document the outbreak context and any relevant laboratory findings

Exclusion Criteria

Do NOT use B33.0 When
  • Exclusion criteria include other viral myalgias that do not fit the epidemic pattern

Related CPT Codes

99213CPT Code

Established patient office visit, Level 3

Clinical Scenario

Used for follow-up visits for symptomatic management of epidemic myalgia.

Documentation Requirements

Document patient history, symptom severity, and treatment plan.

Specialty Considerations

Primary care providers should ensure comprehensive documentation to support the visit level.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of epidemic myalgia, improving the accuracy of data collection and epidemiological tracking of viral outbreaks.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of epidemic myalgia, improving the accuracy of data collection and epidemiological tracking of viral outbreaks.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of epidemic myalgia, improving the accuracy of data collection and epidemiological tracking of viral outbreaks.

Resources

Clinical References

  • •
    CDC Viral Infections Overview

Coding & Billing References

  • •
    CDC Viral Infections Overview

Frequently Asked Questions

What are the common symptoms of epidemic myalgia?

Common symptoms include widespread muscle pain, fever, malaise, and fatigue, often occurring during an outbreak.

How is epidemic myalgia diagnosed?

Diagnosis is primarily clinical, based on patient history and symptomatology, with laboratory tests used to rule out other infections.

What treatments are available for epidemic myalgia?

Treatment is generally supportive, focusing on symptom relief with analgesics and anti-inflammatory medications, as the condition is usually self-limiting.