ICD-10 M79.1
Non-Billable HeaderMyalgia
About ICD-10-CM M79.1
ICD-10-CM code M79.1 represents Myalgia. This is a non-billable header code in the Musculoskeletal and Connective Tissue chapter (block M79). The 2026 edition of ICD-10-CM M79.1 became effective on October 1, 2025. Non-billable codes cannot be used as a primary or secondary diagnosis on a claim, use a more specific child code instead.
Inclusion Terms / Approximate Synonyms
Clinical terms and conditions classified under M79.1. Per CMS ICD-10-CM Tabular 2026.
- Myofascial pain syndrome
Type 1 Excludes
Pure excludes, these codes can never be coded together with M79.1. The conditions are mutually exclusive (e.g., congenital vs acquired forms).
- fibromyalgia (M79.7)
- myositis (M60.-)
Medicare LCD Coverage for M79.1
Local Coverage Determinations (LCDs) from CMS MACs that list M79.1 as a covered diagnosis.
This doesn't mean the code isn't covered, it means no MAC has issued a Local Coverage Determination naming this specific code. Coverage may still apply under National Coverage Determinations or general medical-necessity rules.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing M79.1.
Our payer policy database covers Aetna, Cigna, Anthem, BCBS, Humana, and Medicare Advantage plans, but M79.1 doesn't currently appear in any indexed policy. The code may still be covered under standard plan benefits.
CPT Codes Commonly Billed with M79.1
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
- 20526 Injection of joint or bursa for pain relief Pain Medicine
- 64470 Injection of anesthetic agent into facet joint Pain Medicine
- 64480 Injection of anesthetic agent into facet joint, lumbar or sacrum Pain Medicine
- 64640 Percutaneous implantation of neurostimulator electrodes Pain Medicine
- 64650 Percutaneous implantation of neurostimulator pulse generator Pain Medicine
- 64550 Implantation of spinal cord stimulator Pain Medicine
- 20520 Arthrocentesis, aspiration, and/or injection of joint or bursa Pain Medicine
- 20525 Injection of joint or bursa for pain relief, with fluoroscopic guidance Pain Medicine
- 20600 Arthrocentesis, aspiration, and/or injection of joint or bursa, with ultrasound guidance Pain Medicine
- 20610 Injection of joint or bursa for pain relief, with CT guidance Pain Medicine
Convert M79.1 to ICD-9-CM
Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.
| ICD-10 | ICD-9 | Mapping Flags |
|---|---|---|
| M79.1 | 7291 | 10000 |
Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).
Codes Adjacent To M79.1
Other codes in section M70-M79 (Other soft tissue disorders).
ICD-10 M79.1, Billing FAQ
Is ICD-10 code M79.1 billable? +
No, M79.1 is a non-billable header code. Use a more specific child code from block M79 when submitting claims.
What other names or terms map to M79.1? +
ICD-10 M79.1 includes: Myofascial pain syndrome.
What codes are Type 1 Excludes for M79.1? +
Type 1 Excludes (never code together with M79.1): fibromyalgia (M79.7); myositis (M60.-)
What CPT codes are commonly billed with M79.1? +
Procedures frequently paired with M79.1 include: 20526, 64470, 64480, 64640, 64650.
What ICD-9 codes does M79.1 map to? +
Per CMS GEMs, M79.1 maps to ICD-9 codes: 7291. Useful for legacy data review and historical claim analysis.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on June 1, 2026.
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