M31.5
BillableGiant cell arteritis with polymyalgia rheumatica
HCC Category Mapping
V28HCC 94 — Reactive and Specified Arthropathies
0.000V24HCC 40 — Rheumatoid Arthritis and Inflammatory Connective Tissue Disease
0.307ESRDHCC 40 — Rheumatoid Arthritis and Inflammatory Connective Tissue Disease
0.000RxHCCHCC 84 — Vasculitis and Other Autoimmune Disorders
0.000What This Code Means
A condition where large arteries become inflamed (giant cell arteritis) and is accompanied by muscle pain and stiffness, particularly in the shoulders and hips (polymyalgia rheumatica).
Coding Tips
- •Code both the giant cell arteritis and polymyalgia rheumatica components
- •Document any vision complications or temporal artery involvement
Clinical Significance
Giant cell arteritis with polymyalgia rheumatica represents a combination of large vessel vasculitis with associated muscle pain and stiffness, typically affecting patients over 50 years. This condition carries risk of blindness and requires immediate high-dose corticosteroid treatment.
Documentation Requirements
- ✓Patient age typically over 50 years
- ✓Clinical evidence of giant cell arteritis (temporal artery involvement)
- ✓Concurrent polymyalgia rheumatica symptoms
- ✓Elevated inflammatory markers (ESR, CRP)
- ✓Temporal artery biopsy if performed
- ✓Assessment of visual symptoms
- ✓Response to corticosteroid therapy
- ✓Monitoring for steroid-related complications
Commonly Confused Codes
M31.6 — Other giant cell arteritis (without polymyalgia rheumatica)M35.3 — Polymyalgia rheumatica (without arteritis component)M31.4 — Aortic arch syndrome (Takayasu arteritis)G44.001 — Cluster headache syndrome, unspecified (headache only)H34.10 — Central retinal artery occlusion, unspecified eye (visual complications only)
Code Hierarchy
└M31Other necrotizing vasculopathies└M31.5Giant cell arteritis with polymyalgia rheumatica
└M31.5Giant cell arteritis with polymyalgia rheumatica