{"id":170795,"date":"2026-07-31T13:06:58","date_gmt":"2026-07-31T13:06:58","guid":{"rendered":"https:\/\/pabau.com\/?p=170795"},"modified":"2026-08-17T12:26:26","modified_gmt":"2026-08-17T12:26:26","slug":"icd-10-code-m315","status":"publish","type":"post","link":"https:\/\/pabau.com\/de\/diagnostic-codes\/icd-10-code-m315\/","title":{"rendered":"ICD-10 code M31.5: Giant cell arteritis with polymyalgia rheumatica"},"content":{"rendered":"\n<script type=\"application\/ld+json\">{\"@context\":\"https:\/\/schema.org\",\"@type\":\"MedicalWebPage\",\"headline\":\"ICD-10 code M31.5: Giant cell arteritis with polymyalgia rheumatica\",\"description\":\"ICD-10 code M31.5 (Giant cell arteritis with polymyalgia rheumatica) is billable for 2026. Learn documentation requirements, inclusion terms, M31.5 vs M31.6 differences, and coding tips.\",\"url\":\"https:\/\/pabau.com\/diagnostic-codes\/icd-10-code-m315\/\",\"audience\":{\"@type\":\"MedicalAudience\",\"audienceType\":\"Clinician\"},\"reviewedBy\":{\"@type\":\"Person\",\"name\":\"Dr Vanja Kitanova\",\"jobTitle\":\"Medical Reviewer\",\"affiliation\":{\"@type\":\"Organization\",\"name\":\"Pabau\"},\"knowsAbout\":[\"Medical Coding\",\"Clinical Documentation\",\"Healthcare Billing\",\"Clinical Safety\"],\"sameAs\":\"https:\/\/pabau.com\/blog\/author\/vanja\/\"},\"datePublished\":\"2026-07-31\",\"dateModified\":\"2026-07-31\"}<\/script>\n\n\n        <div id=\"key_takeaways\">\n            <div class=\"header\">\n                                    <img decoding=\"async\" src=\"https:\/\/pabau.com\/wp-content\/uploads\/2025\/12\/Key-Takeaways-Icon.svg\" alt=\"Key takeaways\" height=\"42\" width=\"42\">\n                                <h3>Key takeaways<\/h3>\n            <\/div>\n            <div class=\"list\">\n                                                            <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#3D3D46\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p>ICD-10 code M31.5 is a billable ICD-10-CM diagnosis code for giant cell arteritis with polymyalgia rheumatica.<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#3D3D46\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p>The code needs both conditions documented, so using it without a stated PMR diagnosis is an audit risk.<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#3D3D46\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p>M31.6 covers giant cell arteritis without polymyalgia rheumatica, and mixing up the two codes is the most common error here.<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#3D3D46\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p>M35.3 carries an Excludes1 note for M31.5, so the two codes are never reported on the same claim.<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#3D3D46\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p>Practice management software like Pabau validates code entry at the point of care, so errors surface before submission.<\/p>\n                        <\/div>\n                                                <\/div>\n        <\/div>\n    \n\n\n<p class=\"wp-block-paragraph\">ICD-10 code M31.5 is a billable, specific ICD-10-CM diagnosis code for <strong>giant cell arteritis with polymyalgia rheumatica<\/strong>. The 2026 edition took effect on October 1, 2025. The code is valid for claim submission and reimbursement across US payer systems.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">M31.5 sits in the M30-M36 block (Systemic connective tissue disorders), under the M31 subcategory for other necrotizing vasculopathies. Both <a href=\"https:\/\/www.cms.gov\/medicare\/coding-billing\/icd-10-codes\" target=\"_blank\" rel=\"nofollow noopener\">CMS<\/a> and the National Center for Health Statistics maintain it. The official description reads: <em>Giant cell arteritis with polymyalgia rheumatica<\/em>.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The code needs both diagnoses in the record. If polymyalgia rheumatica is not stated by the treating clinician, M31.6 is the correct code instead. That single distinction drives most denials in this category.<\/p>\n\n\n\n<figure class=\"wp-block-embed is-type-video is-provider-youtube wp-block-embed-youtube wp-embed-aspect-16-9 wp-has-aspect-ratio\">\n<div class=\"wp-block-embed__wrapper\">\n<iframe title=\"ICD-10 Revisions: Stay Updated or Fall Behind\" width=\"800\" height=\"450\" src=\"https:\/\/www.youtube.com\/embed\/bqAyb-BCA0w?feature=oembed\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share\" referrerpolicy=\"strict-origin-when-cross-origin\" allowfullscreen><\/iframe>\n<\/div>\n<\/figure>\n\n\n\n<div style=\"height:35px;width:800px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<h2 class=\"wp-block-heading\">M31.5 code details at a glance<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">The table below summarizes the reference data for the code. Confirm edition validity each October, when CMS publishes its annual update.<\/p>\n\n\n\n<table style=\"width:100%;border-collapse:separate;border-spacing:0;border-radius:12px;overflow:hidden;font-size:15px;line-height:1.5;margin:1.5em 0 2em;box-shadow:0 2px 12px rgba(0,0,0,0.08)\">\n<thead>\n<tr>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Field<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Detail<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Code<\/td>\n<td style=\"padding:12px 16px;color:#374151\">M31.5<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Full description<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Giant cell arteritis with polymyalgia rheumatica<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Code system<\/td>\n<td style=\"padding:12px 16px;color:#374151\">ICD-10-CM (US implementation)<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Parent code<\/td>\n<td style=\"padding:12px 16px;color:#374151\">M31 (Other necrotizing vasculopathies)<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Code block<\/td>\n<td style=\"padding:12px 16px;color:#374151\">M30-M36 (Systemic connective tissue disorders)<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Billable status<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Yes, billable and specific<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Current edition<\/td>\n<td style=\"padding:12px 16px;color:#374151\">2026 ICD-10-CM<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Effective date<\/td>\n<td style=\"padding:12px 16px;color:#374151\">October 1, 2025<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\n\n<p class=\"wp-block-paragraph\">You can check the current edition status with the <a href=\"https:\/\/icd10cmtool.cdc.gov\/\" target=\"_blank\" rel=\"nofollow noopener\">CDC ICD-10-CM tool<\/a>, which mirrors the official tabular list for each update cycle. Run that check at the start of every fiscal year, before the first claims go out.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">What is giant cell arteritis with polymyalgia rheumatica?<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Giant cell arteritis (GCA) is chronic inflammation of large and medium-sized blood vessels, most often the temporal arteries and branches of the aorta. It also goes by temporal arteritis, cranial arteritis, and Horton&#8217;s arteritis.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Polymyalgia rheumatica (PMR) is a related inflammatory condition. It causes pain and stiffness in the shoulders, neck, upper arms, hips, and thighs.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The two conditions co-occur often. Studies suggest 40% to 60% of GCA patients also present with PMR. That overlap is why ICD-10-CM carries a dedicated combination code. GCA with PMR affects adults over 50, with peak incidence between ages 70 and 80.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Key clinical features that support an M31.5 diagnosis:<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>New-onset headache, typically temporal or occipital<\/li><li>Scalp tenderness or temporal artery thickening on palpation<\/li><li>Jaw claudication, meaning pain with chewing<\/li><li>Visual disturbance or transient vision loss<\/li><li>Proximal muscle aching and morning stiffness, which is the PMR component<\/li><li>Elevated erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP)<\/li><li>Temporal artery biopsy showing giant cell infiltration, where one was performed<\/li><\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">Girdle stiffness often sends these patients to physical therapy practices first, so the arteritis diagnosis can arrive weeks after the muscle symptoms do.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Temporal artery biopsy remains the gold standard for confirming GCA. The American College of Rheumatology accepts a clinical diagnosis without biopsy where imaging or presentation is strongly suggestive. For code assignment, what matters is that <strong>both GCA and PMR are documented<\/strong> by the treating clinician.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Inclusion terms and synonyms<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">The ICD-10-CM tabular list treats these terms as applicable to M31.5. Coders will meet any of them in clinical documentation, and all of them map to the same code:<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>Giant cell arteritis with polymyalgia rheumatica<\/li><li>Temporal arteritis with polymyalgia rheumatica<\/li><li>Cranial arteritis with polymyalgia rheumatica<\/li><li>Horton&#8217;s arteritis with polymyalgia rheumatica<\/li><li>GCA with PMR<\/li><\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">These inclusion terms come from the ICD-10-CM Alphabetic Index. The index path runs <em>Arteritis, giant cell, with polymyalgia rheumatica<\/em>, which resolves to M31.5.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">A <a href=\"https:\/\/pabau.com\/industry\/chiropractic-software\/\">chiropractic platform<\/a> connects each spinal or joint diagnosis to its treatment schedule and outcomes.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Exclusion notes: what the code does not cover<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Knowing what the code excludes matters as much as knowing when to use it. Coding the wrong condition here creates audit exposure and payer-level rejections. <\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><img decoding=\"async\" src=\"https:\/\/cdn.pabau.com\/cdn\/attachments\/pulse\/content-engine\/diagnostic_codes\/icd-10-code-m315\/hipaa-compliance-in-pabau.webp\" alt=\"Security and HIPAA compliance settings in Pabau\"\/><figcaption class=\"wp-element-caption\"><em>Pabau&#8217;s HIPAA setting and account security controls protect the records that have to stand up when an M31.5 claim is audited.<\/em><\/figcaption><\/figure>\n\n\n\n<div style=\"height:35px;width:800px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<table style=\"width:100%;border-collapse:separate;border-spacing:0;border-radius:12px;overflow:hidden;font-size:15px;line-height:1.5;margin:1.5em 0 2em;box-shadow:0 2px 12px rgba(0,0,0,0.08)\">\n<thead>\n<tr>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Exclusion type<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">What it means<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Code to use instead<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">GCA without PMR<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Patient has giant cell arteritis but polymyalgia rheumatica is not documented<\/td>\n<td style=\"padding:12px 16px;color:#374151\">M31.6 (Other giant cell arteritis)<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">PMR alone<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Patient has polymyalgia rheumatica without documented GCA<\/td>\n<td style=\"padding:12px 16px;color:#374151\">M35.3 (Polymyalgia rheumatica)<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Other vasculitides<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Conditions like Takayasu arteritis, Wegener&#8217;s granulomatosis, or polyarteritis nodosa<\/td>\n<td style=\"padding:12px 16px;color:#374151\">M31.4, M31.30 or M31.31, M30.0 respectively<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\n\n<p class=\"wp-block-paragraph\">The tabular list settles the pairing with M35.3 outright. Its Excludes1 note reads &#8222;polymyalgia rheumatica with giant cell arteritis (M31.5)&#8220;, so the two codes are officially excluded from being reported together. The PMR component is already captured inside the combination code.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">M31.5 vs M31.6: key differences<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">The one thing separating M31.5 from <a href=\"https:\/\/pabau.com\/diagnostic-codes\/icd-10-code-m316\/\">M31.6<\/a> is whether polymyalgia rheumatica is documented. Getting that wrong is the most common coding error in the giant cell arteritis family. The table below sets the distinction out.<\/p>\n\n\n\n<table style=\"width:100%;border-collapse:separate;border-spacing:0;border-radius:12px;overflow:hidden;font-size:15px;line-height:1.5;margin:1.5em 0 2em;box-shadow:0 2px 12px rgba(0,0,0,0.08)\">\n<thead>\n<tr>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Criteria<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">M31.5<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">M31.6<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Full description<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Giant cell arteritis with polymyalgia rheumatica<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Other giant cell arteritis, without PMR<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">PMR documented?<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Yes, required<\/td>\n<td style=\"padding:12px 16px;color:#374151\">No, absent or not documented<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">GCA documented?<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Yes, required<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Yes, required<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Separate PMR code needed?<\/td>\n<td style=\"padding:12px 16px;color:#374151\">No, PMR is captured in the combination code<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Not applicable<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Billable?<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Yes<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Yes<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Clinical scenario<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Biopsy-confirmed GCA with concurrent PMR symptoms and elevated ESR or CRP<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Biopsy-confirmed GCA with no proximal muscle symptoms or PMR diagnosis in the chart<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\n\n<p class=\"wp-block-paragraph\">The <a href=\"https:\/\/www.aapc.com\/codes\/icd-10-codes-range\/\" target=\"_blank\" rel=\"nofollow noopener\">AAPC code lookup<\/a> lists both codes as billable within the M31 category. Searching the index for &#8222;giant cell arteritis&#8220; alone routes to M31.6. Confirm the PMR documentation before you move the claim to M31.5.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Sibling codes in the M31 category<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">M31 covers other necrotizing vasculopathies inside the wider M30-M36 block. Knowing the siblings helps coders move through the category without landing on the wrong fourth character.<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li><strong>M31.0<\/strong> \u2014 Hypersensitivity angiitis (Goodpasture&#8217;s syndrome)<\/li><li><strong>M31.1<\/strong> \u2014 Thrombotic microangiopathy<\/li><li><strong>M31.2<\/strong> \u2014 Lethal midline granuloma<\/li><li><strong>M31.3<\/strong> \u2014 Wegener&#8217;s granulomatosis (non-billable header, coded to M31.30 or M31.31)<\/li><li><strong>M31.4<\/strong> \u2014 Aortic arch syndrome (Takayasu&#8217;s arteritis)<\/li><li><strong>M31.5<\/strong> \u2014 Giant cell arteritis with polymyalgia rheumatica<\/li><li><strong>M31.6<\/strong> \u2014 Other giant cell arteritis<\/li><li><strong>M31.7<\/strong> \u2014 Microscopic polyangiitis<\/li><li><strong>M31.8<\/strong> \u2014 Other specified necrotizing vasculopathies<\/li><li><strong>M31.9<\/strong> \u2014 Necrotizing vasculopathy, unspecified<\/li><\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">Only M31.3 needs a fifth character. Use <strong>M31.30<\/strong> for Wegener&#8217;s granulomatosis without renal involvement, and <strong>M31.31<\/strong> where the kidneys are involved. M31.3 on its own is a non-billable header code.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The <a href=\"https:\/\/icd.who.int\/browse10\/2019\/en\" target=\"_blank\" rel=\"nofollow noopener\">WHO ICD-10 browser<\/a> shows the international classification that ICD-10-CM is derived from. The M31.5 parent structure is the same in both.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Documentation requirements<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Thin documentation is the main cause of M31.5 rejections. Both halves of the combination code have to be supported in the clinical record. <\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><img decoding=\"async\" src=\"https:\/\/cdn.pabau.com\/cdn\/attachments\/pulse\/content-engine\/diagnostic_codes\/icd-10-code-m315\/customizable-consent-and-intake-forms.webp\" alt=\"Customizable consent and treatment forms in Pabau\"\/><figcaption class=\"wp-element-caption\"><em>Pabau&#8217;s treatment forms carry lab orders and structured findings, so ESR and CRP values reach the record before anyone assigns a code.<\/em><\/figcaption><\/figure>\n\n\n\n<div style=\"height:35px;width:800px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<p class=\"wp-block-paragraph\">These elements should be in the medical record before M31.5 is assigned:<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li><strong>Explicit GCA diagnosis.<\/strong> The clinician has to name giant cell arteritis, temporal arteritis, or cranial arteritis as a confirmed or working diagnosis. A symptom description is not enough.<\/li><li><strong>Explicit PMR diagnosis.<\/strong> Polymyalgia rheumatica needs its own entry. Proximal muscle aching on its own will not support the code.<\/li><li><strong>Symptom documentation.<\/strong> New headache, jaw claudication, scalp tenderness, visual symptoms, or girdle pain, supporting each half of the diagnosis.<\/li><li><strong>Lab findings.<\/strong> Record the ESR and CRP values themselves rather than the word &#8222;elevated&#8220;, since thresholds vary by laboratory reference range.<\/li><li><strong>Biopsy results.<\/strong> Where a temporal artery biopsy was performed, record the finding. A negative biopsy still allows M31.5 if clinical criteria are met and the clinician documents the reasoning.<\/li><li><strong>Treatment plan.<\/strong> Corticosteroid initiation or tapering, documented in line with GCA and PMR management.<\/li><\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">Rheumatology encounter templates that prompt for all six cut down on retrospective physician queries. Those queries arrive weeks later, when nobody remembers the visit.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Once the encounter is written up. Tying documentation templates to code-specific requirements.<\/p>\n\n\n        <div id=\"pro_tip\">\n            <div class=\"img\">\n                <svg width=\"42\" height=\"42\" viewBox=\"0 0 42 42\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                    <path fill-rule=\"evenodd\" clip-rule=\"evenodd\"\n                        d=\"M12.6383 19.5238C12.6632 21.2071 12.8734 22.9926 12.0685 24.5523C11.0341 26.8917 8.45076 28.169 7.56292 30.5918C6.63082 33.1061 7.19505 36.185 9.31371 37.9786C10.929 39.5678 13.4183 39.9873 15.6061 39.5463C17.4592 39.073 19.1049 37.8388 19.9706 36.1608C20.781 34.7141 20.7866 32.9904 20.5293 31.3985C20.1006 29.3092 18.3775 27.8705 16.9807 26.362C14.8814 24.1005 14.6684 20.6854 15.595 17.8915C16.4331 15.4768 19.0026 14.2344 20.0425 11.9461C20.7202 10.6769 20.7506 9.20327 20.6068 7.81304C20.1864 5.40098 18.3139 3.23631 15.8716 2.56674C13.9742 2.03969 11.8224 2.30052 10.1739 3.37614C8.70522 4.34688 7.5878 5.86618 7.28356 7.58178C6.76081 9.82981 7.53525 12.2822 9.20307 13.9118C10.7658 15.4741 12.4806 17.2273 12.6383 19.5238Z\"\n                        fill=\"#2BADD4\" \/>\n                    <path fill-rule=\"evenodd\" clip-rule=\"evenodd\"\n                        d=\"M22.7048 19.8387C22.6822 22.3279 24.4507 24.6234 26.7493 25.4682C28.0531 25.961 29.4725 25.9183 30.7989 25.5487C32.0575 24.9955 33.301 24.2237 34.0069 23.0092C34.8384 21.5811 35.2982 19.8286 34.7832 18.2094C34.3611 16.2507 32.8739 14.6541 31.0275 13.9426C28.6736 12.9595 25.8073 13.7942 24.1719 15.7001C23.2022 16.8366 22.6143 18.3326 22.7048 19.8387Z\"\n                        fill=\"#2BADD4\" \/>\n                <\/svg>\n            <\/div>\n            <div class=\"text\">\n                <h3>Pro Tip<\/h3>\n                <p>Document both the GCA and PMR diagnoses by their full clinical names in the assessment section, not only in the problem list. Payers reviewing medical necessity read the assessment and plan first. A problem-list entry will not support M31.5 if the assessment says only &#8218;temporal headache&#8216; or &#8217;shoulder pain&#8216;.<\/p>\n            <\/div>\n        <\/div>\n    \n\n\n<h2 class=\"wp-block-heading\">Coding tips and common pitfalls<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Rheumatology billers hit a predictable set of errors with this code. These five account for most rejections and audit findings in the category.<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li><strong>Using M31.5 when PMR is suspected but not documented.<\/strong> Clinical suspicion does not justify the combination code. The physician has to state the diagnosis. Where only GCA is confirmed, use M31.6.<\/li><li><strong>Adding M35.3 alongside M31.5.<\/strong> The Excludes1 note rules the pairing out, and payers read the duplicate as unbundling.<\/li><li><strong>Defaulting to M31.6 for every GCA encounter.<\/strong> Coders who never query the chart for PMR will under-code by habit. Query the physician when the chart mentions shoulder or hip girdle complaints.<\/li><li><strong>Reaching for the unspecified code M31.9.<\/strong> M31.5 is billable and specific. Using M31.9 where documentation supports M31.5 costs reimbursement and invites a compliance finding.<\/li><li><strong>Entering through the wrong index term.<\/strong> <em>Arteritis<\/em> &gt; <em>giant cell<\/em> &gt; <em>with polymyalgia rheumatica<\/em> gives M31.5. Entering under <em>Polymyalgia<\/em> &gt; <em>rheumatica<\/em> gives M35.3.<\/li><\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">Diagnostic code validation flags these patterns before a claim leaves the practice. That pays off most where older patients dominate the caseload.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Structured coding workflows protect the revenue side too. Code validation is worth testing on any demo.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Alphabetic index entry paths<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Coders reach M31.5 through several routes in the ICD-10-CM Alphabetic Index. Knowing them prevents mislookups that land on M31.6 or M35.3:<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li><strong>Arteritis<\/strong> &gt; giant cell &gt; with polymyalgia rheumatica = <strong>M31.5<\/strong><\/li><li><strong>Arteritis<\/strong> &gt; temporal &gt; with polymyalgia rheumatica = <strong>M31.5<\/strong><\/li><li><strong>Horton&#8217;s disease<\/strong> &gt; with polymyalgia rheumatica = <strong>M31.5<\/strong><\/li><li><strong>Giant cell arteritis<\/strong> &gt; with polymyalgia rheumatica = <strong>M31.5<\/strong><\/li><\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">Entering <strong>polymyalgia rheumatica<\/strong> as the primary index term lands on M35.3 instead. The coder has to enter through the arteritis path and confirm the PMR qualifier to reach M31.5.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Related ICD-10 codes<\/h2>\n\n\n\n<ul class=\"wp-block-list\">\n<li><a href=\"https:\/\/pabau.com\/diagnostic-codes\/icd-10-code-m1990\/\">ICD-10 code M19.90 \u2014 Degenerative Joint Disease Documentation<\/a><\/li>\n\n\n<li><a href=\"https:\/\/pabau.com\/diagnostic-codes\/icd-10-code-m317\/\">ICD-10 code M31.7 \u2014 Microscopic polyangiitis<\/a><\/li>\n\n\n<li><a href=\"https:\/\/pabau.com\/diagnostic-codes\/icd-10-code-m029\/\">ICD-10 code M02.9 \u2014 Reactive arthropathy, unspecified<\/a><\/li>\n<\/ul>\n\n\n\n<h2 class=\"wp-block-heading\">How Pabau keeps M31.5 documentation and claims aligned<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">M31.5 usually goes wrong at the point of care rather than at the coding desk. The clinician sees both conditions, treats both, and writes up one. By the time the coder opens the chart, the PMR diagnosis exists only in the physician&#8217;s memory.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">A rheumatology workflow for this code covers five things:<\/p>\n\n\n\n<ol class=\"wp-block-list\"><li><strong>Structured encounter templates<\/strong> that prompt for the GCA and PMR diagnoses separately in the assessment, not just the problem list<\/li><li><strong>Code lookup at charge entry<\/strong> that surfaces M31.5 on a search for &#8222;giant cell arteritis&#8220; and asks for PMR confirmation first<\/li><li><strong>Combination code alerts<\/strong> that block M31.5 and M35.3 from being entered together, killing the unbundling error at source<\/li><li><strong>Lab result integration<\/strong> that attaches ESR and CRP values to the encounter, so medical necessity is evidenced at submission<\/li><li><strong>Claim scrubbing rules<\/strong> that check payer-specific edits and documentation requirements before the claim goes out<\/li><\/ol>\n\n\n\n<p class=\"wp-block-paragraph\">Pabau&#8217;s claims management software handles diagnostic code entry and claim workflow for multi-specialty practices. Structured encounter notes hold both diagnoses the code requires, so payer queries have somewhere to land.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Pabau Scribe, our AI scribe, sits on top of that. It turns the consultation into a structured note, prompting for the GCA diagnosis, the PMR diagnosis, and the lab values that hold the claim up. You can see how AI-assisted documentation fits a day in a rheumatology practice.<\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><img decoding=\"async\" src=\"https:\/\/cdn.pabau.com\/cdn\/attachments\/pulse\/content-engine\/diagnostic_codes\/icd-10-code-m315\/automate-claims-through-healthcode.webp\" alt=\"Automated checkout and insurer invoicing in Pabau\"\/><figcaption class=\"wp-element-caption\"><em>Pabau raises the insurer invoice at checkout, so the diagnosis coded in the note travels with the claim instead of being rekeyed.<\/em><\/figcaption><\/figure>\n\n\n\n<div style=\"height:35px;width:800px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n        <div id=\"book_a_demo\">\n            <div class=\"left-side\">\n                <div class=\"logo\">\n                    <img decoding=\"async\"\n                        src=\"https:\/\/pabau.com\/wp-content\/uploads\/2026\/01\/Logo.svg\"\n                        alt=\"Logo\"\n                        loading=\"lazy\"\n                    \/>\n                <\/div>\n\n                <h3 class=\"heading\">\n                    Catch coding errors before the claim goes out                <\/h3>\n\n                <p class=\"description\">\n                    Pabau helps rheumatology and multi-specialty practices build documentation workflows that capture what M31.5 needs. Both diagnoses get recorded while the patient is still in the room.                <\/p>\n\n                <div class=\"button-group\">\n                    <a href=\"\/book-demo\/\" class=\"btn btn-scale-effect btn-cta-color btn-md\">\n                        <span class=\"btn-text\">Book a demo<\/span>\n                        <div class=\"btn-icon btn-icon-right\" aria-hidden=\"true\">\n                            <svg\n                                width=\"14\"\n                                height=\"12\"\n                                viewBox=\"0 0 14 12\"\n                                fill=\"none\"\n                                xmlns=\"http:\/\/www.w3.org\/2000\/svg\"\n                            >\n                                <path\n                                    d=\"M0.75 4.77295C0.335786 4.77295 0 5.10874 0 5.52295C0 5.93716 0.335786 6.27295 0.75 6.27295V5.52295V4.77295ZM13.2803 6.05328C13.5732 5.76039 13.5732 5.28551 13.2803 4.99262L8.50736 0.219648C8.21447 -0.073245 7.73959 -0.073245 7.4467 0.219648C7.15381 0.512542 7.15381 0.987415 7.4467 1.28031L11.6893 5.52295L7.4467 9.76559C7.15381 10.0585 7.15381 10.5334 7.4467 10.8263C7.73959 11.1191 8.21447 11.1191 8.50736 10.8263L13.2803 6.05328ZM0.75 5.52295V6.27295L12.75 6.27295V5.52295V4.77295L0.75 4.77295V5.52295Z\"\n                                    fill=\"currentColor\"\n                                ><\/path>\n                            <\/svg>\n                        <\/div>\n                    <\/a>\n                <\/div>\n            <\/div>\n\n            <div class=\"right-side\">\n                <img decoding=\"async\"\n                    src=\"https:\/\/pabau.com\/wp-content\/uploads\/2026\/01\/Home-Page-Concept-4.webp\"\n                    alt=\"Pabau practice management dashboard\"\n                    loading=\"lazy\"\n                \/>\n            <\/div>\n        <\/div>\n        \n\n\n<h2 class=\"wp-block-heading\">Conclusion<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">The choice between M31.5 and M31.6 is settled in the encounter note, not at charge entry. If the clinician names both diagnoses, the combination code is defensible. If not, no coder can rescue it afterwards.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">So treat this as a documentation habit rather than a coding one. Put the PMR prompt inside the rheumatology template and the right code follows on its own. The trade-off is a few extra seconds in the assessment field, against a denial that costs an hour to appeal.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Get that habit in place and M31.5 stops being a category you audit and starts being one you trust. <a href=\"https:\/\/pabau.com\/book-demo\/\">Book a demo<\/a> to see how Pabau structures rheumatology documentation and claims.<\/p>\n\n\n        <div id=\"expert_picks\">\n            <div class=\"header\">\n                                    <img decoding=\"async\" src=\"https:\/\/pabau.com\/wp-content\/uploads\/2025\/11\/Expert-Picks.svg\" alt=\"Continue your research\" height=\"42\" width=\"42\">\n                                <h3>Continue your research<\/h3>\n            <\/div>\n            <div class=\"content\">\n                                                            <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#54B2D3\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p><strong>Coding giant cell arteritis when PMR is absent?<\/strong> <a href=\"https:\/\/pabau.com\/diagnostic-codes\/icd-10-code-m316\/\" rel=\"noopener\">M31.6<\/a> covers the standalone code and what the chart has to show.<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#54B2D3\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p><strong>Need the standalone polymyalgia rheumatica code?<\/strong> <a href=\"https:\/\/pabau.com\/diagnostic-codes\/icd-10-code-m353\/\" rel=\"noopener\">M35.3<\/a> sets out when PMR is reported on its own.<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#54B2D3\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p><strong>Ruling out Takayasu arteritis instead?<\/strong> <a href=\"https:\/\/pabau.com\/diagnostic-codes\/icd-10-code-m314\/\" rel=\"noopener\">M31.4<\/a> explains the aortic arch syndrome code and its documentation.<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#54B2D3\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p><strong>Documenting polyarteritis nodosa?<\/strong> <a href=\"https:\/\/pabau.com\/diagnostic-codes\/icd-10-code-m300\/\" rel=\"noopener\">M30.0<\/a> walks through the code and the findings payers expect.<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#54B2D3\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p><strong>Coding vasculitis in a younger patient?<\/strong> <a href=\"https:\/\/pabau.com\/diagnostic-codes\/icd-10-code-m302\/\" rel=\"noopener\">M30.2<\/a> walks through juvenile polyarteritis and its documentation rules.<\/p>\n                        <\/div>\n                                                <\/div>\n        <\/div>\n    \n\n\n<h2 class=\"wp-block-heading\">Frequently asked questions<\/h2>\n\n\n\n<div class=\"schema-faq wp-block-yoast-faq-block\"><div class=\"schema-faq-section\" id=\"faq-question-1785497485904\"><h3 class=\"schema-faq-question\">What is ICD-10 code M31.5 used for?<\/h3> <p class=\"schema-faq-answer\">ICD-10 code M31.5 records giant cell arteritis with polymyalgia rheumatica for reimbursement and documentation in US healthcare settings. It is billable and valid for claim submission under the 2026 edition of ICD-10-CM, effective October 1, 2025.<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1785497485905\"><h3 class=\"schema-faq-question\">What is the difference between M31.5 and M31.6?<\/h3> <p class=\"schema-faq-answer\">M31.5 codes giant cell arteritis with polymyalgia rheumatica documented alongside it. M31.6 codes other giant cell arteritis, where PMR is absent or not documented. The only differentiating factor is whether polymyalgia rheumatica is stated in the clinical record.<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1785497485906\"><h3 class=\"schema-faq-question\">Is M31.5 a billable ICD-10 code?<\/h3> <p class=\"schema-faq-answer\">Yes, M31.5 is a billable and specific ICD-10-CM code, valid for submission to payers. It is not a non-billable header code. Coverage policies still vary, so verify medical necessity criteria with each payer for your patient population.<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1785497485907\"><h3 class=\"schema-faq-question\">What documentation is required to use M31.5?<\/h3> <p class=\"schema-faq-answer\">The record must explicitly document giant cell arteritis and polymyalgia rheumatica as diagnosed conditions. Supporting elements include symptoms for each condition, the recorded ESR and CRP values, and biopsy findings where a temporal artery biopsy was performed.<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1785497485908\"><h3 class=\"schema-faq-question\">Can M31.5 and M35.3 be coded together?<\/h3> <p class=\"schema-faq-answer\">No. The Excludes1 note under M35.3 reads &#8222;polymyalgia rheumatica with giant cell arteritis (M31.5)&#8220;, so the two codes cannot be reported together. The PMR component is already captured inside the M31.5 combination code.<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1785497485909\"><h3 class=\"schema-faq-question\">When did the 2026 version of M31.5 take effect?<\/h3> <p class=\"schema-faq-answer\">The 2026 edition of ICD-10-CM M31.5 took effect on October 1, 2025. CMS and NCHS publish annual updates every October 1. Verify the current edition with the CDC ICD-10-CM tool at the start of each fiscal year.<\/p> <\/div> <\/div>\n\n","protected":false},"excerpt":{"rendered":"<p>ICD-10 code M31.5 is a billable, specific ICD-10-CM diagnosis code for giant cell arteritis with polymyalgia rheumatica. The 2026 edition took effect on October 1, 2025. The code is valid for claim submission and reimbursement across US payer systems. M31.5 sits in the M30-M36 block (Systemic connective tissue disorders), under the M31 subcategory for other [&hellip;]<\/p>\n","protected":false},"author":81,"featured_media":170792,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_yoast_wpseo_linkdex":"","_yoast_wpseo_content_score":"90","_yoast_wpseo_is_cornerstone":"","_yoast_wpseo_keywordsynonyms":"[\"\",\"\",\"\",\"\",\"\",\"\"]","_yoast_wpseo_focuskw_text_input":"","_seo_original_html":"","footnotes":""},"categories":[1549,1550,1125],"tags":[2508,2977,2635],"class_list":["post-170795","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-diagnostic-codes","category-icd-10-cm","category-musculoskeletal-pain-management","tag-medical-coding","tag-medical-coding-standards","tag-rheumatology-coding"],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v28.2 (Yoast SEO v28.2) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>ICD-10 code M31.5: Billable status, documentation, M31.6 split<\/title>\n<meta name=\"description\" content=\"M31.5 is billable only when both giant cell arteritis and polymyalgia rheumatica are documented. Without a stated PMR diagnosis, use M31.6.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/pabau.com\/de\/diagnostic-codes\/icd-10-code-m315\/\" \/>\n<meta property=\"og:locale\" content=\"de_DE\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"ICD-10 code M31.5: Billable status, documentation, M31.6 split\" \/>\n<meta property=\"og:description\" content=\"M31.5 is billable only when both giant cell arteritis and polymyalgia rheumatica are documented. Without a stated PMR diagnosis, use M31.6.\" \/>\n<meta property=\"og:url\" content=\"https:\/\/pabau.com\/de\/diagnostic-codes\/icd-10-code-m315\/\" \/>\n<meta property=\"og:site_name\" content=\"Pabau\" \/>\n<meta property=\"article:publisher\" content=\"https:\/\/www.facebook.com\/Pabau\/\" \/>\n<meta property=\"article:published_time\" content=\"2026-07-31T13:06:58+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2026-08-17T12:26:26+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/pabau.com\/wp-content\/uploads\/2026\/07\/icd-10-code-m315.webp\" \/>\n\t<meta property=\"og:image:width\" content=\"1200\" \/>\n\t<meta property=\"og:image:height\" content=\"630\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/webp\" \/>\n<meta name=\"author\" content=\"Aleksandar Kochovski\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:creator\" content=\"@pabaucrm\" \/>\n<meta name=\"twitter:site\" content=\"@pabaucrm\" \/>\n<meta name=\"twitter:label1\" content=\"Verfasst von\" \/>\n\t<meta name=\"twitter:data1\" content=\"Aleksandar Kochovski\" \/>\n\t<meta name=\"twitter:label2\" content=\"Gesch\u00e4tzte Lesezeit\" \/>\n\t<meta name=\"twitter:data2\" content=\"1\u00a0Minute\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\\\/\\\/pabau.com\\\/de\\\/diagnostic-codes\\\/icd-10-code-m315\\\/#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/pabau.com\\\/de\\\/diagnostic-codes\\\/icd-10-code-m315\\\/\"},\"author\":{\"name\":\"Aleksandar Kochovski\",\"@id\":\"https:\\\/\\\/pabau.com\\\/de\\\/#\\\/schema\\\/person\\\/73b672a49e20bfba8161e3c17ee3dda2\"},\"headline\":\"ICD-10 code M31.5: Giant cell arteritis with polymyalgia rheumatica\",\"datePublished\":\"2026-07-31T13:06:58+00:00\",\"dateModified\":\"2026-08-17T12:26:26+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\\\/\\\/pabau.com\\\/de\\\/diagnostic-codes\\\/icd-10-code-m315\\\/\"},\"wordCount\":2166,\"publisher\":{\"@id\":\"https:\\\/\\\/pabau.com\\\/de\\\/#organization\"},\"image\":{\"@id\":\"https:\\\/\\\/pabau.com\\\/de\\\/diagnostic-codes\\\/icd-10-code-m315\\\/#primaryimage\"},\"thumbnailUrl\":\"https:\\\/\\\/pabau.com\\\/wp-content\\\/uploads\\\/2026\\\/07\\\/icd-10-code-m315.webp\",\"keywords\":[\"Medical Coding\",\"Medical Coding Standards\",\"Rheumatology coding\"],\"articleSection\":[\"Diagnostic Codes\",\"ICD-10-CM\",\"Musculoskeletal &amp; Pain Management\"],\"inLanguage\":\"de\"},{\"@type\":[\"WebPage\",\"FAQPage\"],\"@id\":\"https:\\\/\\\/pabau.com\\\/de\\\/diagnostic-codes\\\/icd-10-code-m315\\\/\",\"url\":\"https:\\\/\\\/pabau.com\\\/de\\\/diagnostic-codes\\\/icd-10-code-m315\\\/\",\"name\":\"ICD-10 code M31.5: Billable status, documentation, M31.6 split\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/pabau.com\\\/de\\\/#website\"},\"primaryImageOfPage\":{\"@id\":\"https:\\\/\\\/pabau.com\\\/de\\\/diagnostic-codes\\\/icd-10-code-m315\\\/#primaryimage\"},\"image\":{\"@id\":\"https:\\\/\\\/pabau.com\\\/de\\\/diagnostic-codes\\\/icd-10-code-m315\\\/#primaryimage\"},\"thumbnailUrl\":\"https:\\\/\\\/pabau.com\\\/wp-content\\\/uploads\\\/2026\\\/07\\\/icd-10-code-m315.webp\",\"datePublished\":\"2026-07-31T13:06:58+00:00\",\"dateModified\":\"2026-08-17T12:26:26+00:00\",\"description\":\"M31.5 is billable only when both giant cell arteritis and polymyalgia rheumatica are documented. 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It combines scheduling, electronic health records, clinical forms, payments, marketing automation, reporting, and patient engagement tools into one secure cloud system to help practices streamline operations and grow their business.\",\"foundingDate\":\"2011-10-20\",\"numberOfEmployees\":{\"@type\":\"QuantitativeValue\",\"minValue\":\"201\",\"maxValue\":\"500\"}},{\"@type\":\"Person\",\"@id\":\"https:\\\/\\\/pabau.com\\\/de\\\/#\\\/schema\\\/person\\\/73b672a49e20bfba8161e3c17ee3dda2\",\"name\":\"Aleksandar Kochovski\",\"image\":{\"@type\":\"ImageObject\",\"inLanguage\":\"de\",\"@id\":\"https:\\\/\\\/pabau.com\\\/wp-content\\\/uploads\\\/2026\\\/06\\\/cropped-aleksandar-kochovski-profile-picture-96x96.jpeg\",\"url\":\"https:\\\/\\\/pabau.com\\\/wp-content\\\/uploads\\\/2026\\\/06\\\/cropped-aleksandar-kochovski-profile-picture-96x96.jpeg\",\"contentUrl\":\"https:\\\/\\\/pabau.com\\\/wp-content\\\/uploads\\\/2026\\\/06\\\/cropped-aleksandar-kochovski-profile-picture-96x96.jpeg\",\"caption\":\"Aleksandar Kochovski\"},\"description\":\"Aleksandar is a content strategist and editor working in tech publishing, with a background in higher education. 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It is billable and valid for claim submission under the 2026 edition of ICD-10-CM, effective October 1, 2025.\",\"inLanguage\":\"de\"},\"inLanguage\":\"de\"},{\"@type\":\"Question\",\"@id\":\"https:\\\/\\\/pabau.com\\\/de\\\/diagnostic-codes\\\/icd-10-code-m315\\\/#faq-question-1785497485905\",\"position\":2,\"url\":\"https:\\\/\\\/pabau.com\\\/de\\\/diagnostic-codes\\\/icd-10-code-m315\\\/#faq-question-1785497485905\",\"name\":\"What is the difference between M31.5 and M31.6?\",\"answerCount\":1,\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"M31.5 codes giant cell arteritis with polymyalgia rheumatica documented alongside it. M31.6 codes other giant cell arteritis, where PMR is absent or not documented. The only differentiating factor is whether polymyalgia rheumatica is stated in the clinical record.\",\"inLanguage\":\"de\"},\"inLanguage\":\"de\"},{\"@type\":\"Question\",\"@id\":\"https:\\\/\\\/pabau.com\\\/de\\\/diagnostic-codes\\\/icd-10-code-m315\\\/#faq-question-1785497485906\",\"position\":3,\"url\":\"https:\\\/\\\/pabau.com\\\/de\\\/diagnostic-codes\\\/icd-10-code-m315\\\/#faq-question-1785497485906\",\"name\":\"Is M31.5 a billable ICD-10 code?\",\"answerCount\":1,\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"Yes, M31.5 is a billable and specific ICD-10-CM code, valid for submission to payers. It is not a non-billable header code. 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Supporting elements include symptoms for each condition, the recorded ESR and CRP values, and biopsy findings where a temporal artery biopsy was performed.\",\"inLanguage\":\"de\"},\"inLanguage\":\"de\"},{\"@type\":\"Question\",\"@id\":\"https:\\\/\\\/pabau.com\\\/de\\\/diagnostic-codes\\\/icd-10-code-m315\\\/#faq-question-1785497485908\",\"position\":5,\"url\":\"https:\\\/\\\/pabau.com\\\/de\\\/diagnostic-codes\\\/icd-10-code-m315\\\/#faq-question-1785497485908\",\"name\":\"Can M31.5 and M35.3 be coded together?\",\"answerCount\":1,\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"No. The Excludes1 note under M35.3 reads \\\"polymyalgia rheumatica with giant cell arteritis (M31.5)\\\", so the two codes cannot be reported together. 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Without a stated PMR diagnosis, use M31.6.","og_url":"https:\/\/pabau.com\/de\/diagnostic-codes\/icd-10-code-m315\/","og_site_name":"Pabau","article_publisher":"https:\/\/www.facebook.com\/Pabau\/","article_published_time":"2026-07-31T13:06:58+00:00","article_modified_time":"2026-08-17T12:26:26+00:00","og_image":[{"width":1200,"height":630,"url":"https:\/\/pabau.com\/wp-content\/uploads\/2026\/07\/icd-10-code-m315.webp","type":"image\/webp"}],"author":"Aleksandar Kochovski","twitter_card":"summary_large_image","twitter_creator":"@pabaucrm","twitter_site":"@pabaucrm","twitter_misc":{"Verfasst von":"Aleksandar Kochovski","Gesch\u00e4tzte Lesezeit":"1\u00a0Minute"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"Article","@id":"https:\/\/pabau.com\/de\/diagnostic-codes\/icd-10-code-m315\/#article","isPartOf":{"@id":"https:\/\/pabau.com\/de\/diagnostic-codes\/icd-10-code-m315\/"},"author":{"name":"Aleksandar Kochovski","@id":"https:\/\/pabau.com\/de\/#\/schema\/person\/73b672a49e20bfba8161e3c17ee3dda2"},"headline":"ICD-10 code M31.5: Giant cell arteritis with polymyalgia rheumatica","datePublished":"2026-07-31T13:06:58+00:00","dateModified":"2026-08-17T12:26:26+00:00","mainEntityOfPage":{"@id":"https:\/\/pabau.com\/de\/diagnostic-codes\/icd-10-code-m315\/"},"wordCount":2166,"publisher":{"@id":"https:\/\/pabau.com\/de\/#organization"},"image":{"@id":"https:\/\/pabau.com\/de\/diagnostic-codes\/icd-10-code-m315\/#primaryimage"},"thumbnailUrl":"https:\/\/pabau.com\/wp-content\/uploads\/2026\/07\/icd-10-code-m315.webp","keywords":["Medical Coding","Medical Coding Standards","Rheumatology coding"],"articleSection":["Diagnostic Codes","ICD-10-CM","Musculoskeletal &amp; Pain Management"],"inLanguage":"de"},{"@type":["WebPage","FAQPage"],"@id":"https:\/\/pabau.com\/de\/diagnostic-codes\/icd-10-code-m315\/","url":"https:\/\/pabau.com\/de\/diagnostic-codes\/icd-10-code-m315\/","name":"ICD-10 code M31.5: Billable status, documentation, M31.6 split","isPartOf":{"@id":"https:\/\/pabau.com\/de\/#website"},"primaryImageOfPage":{"@id":"https:\/\/pabau.com\/de\/diagnostic-codes\/icd-10-code-m315\/#primaryimage"},"image":{"@id":"https:\/\/pabau.com\/de\/diagnostic-codes\/icd-10-code-m315\/#primaryimage"},"thumbnailUrl":"https:\/\/pabau.com\/wp-content\/uploads\/2026\/07\/icd-10-code-m315.webp","datePublished":"2026-07-31T13:06:58+00:00","dateModified":"2026-08-17T12:26:26+00:00","description":"M31.5 is billable only when both giant cell arteritis and polymyalgia rheumatica are documented. 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It combines scheduling, electronic health records, clinical forms, payments, marketing automation, reporting, and patient engagement tools into one secure cloud system to help practices streamline operations and grow their business.","foundingDate":"2011-10-20","numberOfEmployees":{"@type":"QuantitativeValue","minValue":"201","maxValue":"500"}},{"@type":"Person","@id":"https:\/\/pabau.com\/de\/#\/schema\/person\/73b672a49e20bfba8161e3c17ee3dda2","name":"Aleksandar Kochovski","image":{"@type":"ImageObject","inLanguage":"de","@id":"https:\/\/pabau.com\/wp-content\/uploads\/2026\/06\/cropped-aleksandar-kochovski-profile-picture-96x96.jpeg","url":"https:\/\/pabau.com\/wp-content\/uploads\/2026\/06\/cropped-aleksandar-kochovski-profile-picture-96x96.jpeg","contentUrl":"https:\/\/pabau.com\/wp-content\/uploads\/2026\/06\/cropped-aleksandar-kochovski-profile-picture-96x96.jpeg","caption":"Aleksandar Kochovski"},"description":"Aleksandar is a content strategist and editor working in tech publishing, with a background in higher education. He specializes in topics around compliance in software solutions. When he's not writing at Pabau, you can find him tending to his bonsai collection or hitting the gym.","url":"https:\/\/pabau.com\/de\/blog\/author\/aleksandar-kochovski\/"},{"@type":"Question","@id":"https:\/\/pabau.com\/de\/diagnostic-codes\/icd-10-code-m315\/#faq-question-1785497485904","position":1,"url":"https:\/\/pabau.com\/de\/diagnostic-codes\/icd-10-code-m315\/#faq-question-1785497485904","name":"What is ICD-10 code M31.5 used for?","answerCount":1,"acceptedAnswer":{"@type":"Answer","text":"ICD-10 code M31.5 records giant cell arteritis with polymyalgia rheumatica for reimbursement and documentation in US healthcare settings. It is billable and valid for claim submission under the 2026 edition of ICD-10-CM, effective October 1, 2025.","inLanguage":"de"},"inLanguage":"de"},{"@type":"Question","@id":"https:\/\/pabau.com\/de\/diagnostic-codes\/icd-10-code-m315\/#faq-question-1785497485905","position":2,"url":"https:\/\/pabau.com\/de\/diagnostic-codes\/icd-10-code-m315\/#faq-question-1785497485905","name":"What is the difference between M31.5 and M31.6?","answerCount":1,"acceptedAnswer":{"@type":"Answer","text":"M31.5 codes giant cell arteritis with polymyalgia rheumatica documented alongside it. M31.6 codes other giant cell arteritis, where PMR is absent or not documented. The only differentiating factor is whether polymyalgia rheumatica is stated in the clinical record.","inLanguage":"de"},"inLanguage":"de"},{"@type":"Question","@id":"https:\/\/pabau.com\/de\/diagnostic-codes\/icd-10-code-m315\/#faq-question-1785497485906","position":3,"url":"https:\/\/pabau.com\/de\/diagnostic-codes\/icd-10-code-m315\/#faq-question-1785497485906","name":"Is M31.5 a billable ICD-10 code?","answerCount":1,"acceptedAnswer":{"@type":"Answer","text":"Yes, M31.5 is a billable and specific ICD-10-CM code, valid for submission to payers. It is not a non-billable header code. Coverage policies still vary, so verify medical necessity criteria with each payer for your patient population.","inLanguage":"de"},"inLanguage":"de"},{"@type":"Question","@id":"https:\/\/pabau.com\/de\/diagnostic-codes\/icd-10-code-m315\/#faq-question-1785497485907","position":4,"url":"https:\/\/pabau.com\/de\/diagnostic-codes\/icd-10-code-m315\/#faq-question-1785497485907","name":"What documentation is required to use M31.5?","answerCount":1,"acceptedAnswer":{"@type":"Answer","text":"The record must explicitly document giant cell arteritis and polymyalgia rheumatica as diagnosed conditions. Supporting elements include symptoms for each condition, the recorded ESR and CRP values, and biopsy findings where a temporal artery biopsy was performed.","inLanguage":"de"},"inLanguage":"de"},{"@type":"Question","@id":"https:\/\/pabau.com\/de\/diagnostic-codes\/icd-10-code-m315\/#faq-question-1785497485908","position":5,"url":"https:\/\/pabau.com\/de\/diagnostic-codes\/icd-10-code-m315\/#faq-question-1785497485908","name":"Can M31.5 and M35.3 be coded together?","answerCount":1,"acceptedAnswer":{"@type":"Answer","text":"No. The Excludes1 note under M35.3 reads \"polymyalgia rheumatica with giant cell arteritis (M31.5)\", so the two codes cannot be reported together. The PMR component is already captured inside the M31.5 combination code.","inLanguage":"de"},"inLanguage":"de"},{"@type":"Question","@id":"https:\/\/pabau.com\/de\/diagnostic-codes\/icd-10-code-m315\/#faq-question-1785497485909","position":6,"url":"https:\/\/pabau.com\/de\/diagnostic-codes\/icd-10-code-m315\/#faq-question-1785497485909","name":"When did the 2026 version of M31.5 take effect?","answerCount":1,"acceptedAnswer":{"@type":"Answer","text":"The 2026 edition of ICD-10-CM M31.5 took effect on October 1, 2025. CMS and NCHS publish annual updates every October 1. Verify the current edition with the CDC ICD-10-CM tool at the start of each fiscal year.","inLanguage":"de"},"inLanguage":"de"}]}},"yoast":{"focus_keyword":"ICD-10 code M31.5","seo_title":"ICD-10 code M31.5: Billable status, documentation, M31.6 split","meta_description":"M31.5 is billable only when both giant cell arteritis and polymyalgia rheumatica are documented. 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