F43.21 - Adjustment disorder with depressed mood

Clinical Definition

Polymyalgia rheumatica (PMR) is an inflammatory disorder causing muscle pain and stiffness, primarily in the shoulders, upper arms, neck, hips, and thighs. It typically affects adults over 50 and is often associated with morning stiffness lasting more than 45 minutes.

Documentation Requirements

• Age of patient (must be >50 years typically)

• Duration of symptoms (at least 2-4 weeks)

• Location of pain/stiffness:

  • Bilateral shoulder girdle pain/stiffness

  • Hip girdle involvement

  • Neck pain if present

• Timing of stiffness (morning stiffness >45 minutes)

• Lab Values:

  • Elevated ESR (>40mm/hr)

  • Elevated CRP

• Response to low-dose glucocorticoids

Common Synonyms

• "Old person's muscle ache"

• "Shoulder-hip syndrome"

• "Morning pain syndrome"

• "Rheumatic muscle inflammation"

Coding Conflicts

Excludes1:

• Giant cell arteritis (M31.5-M31.6)

• Rheumatoid arthritis (M05.-)

• Fibromyalgia (M79.7)

Scribing.io Automation

The AI scribe automatically identifies:

• Age-related context clues

• Bilateral nature of symptoms

• Morning stiffness duration

• Specific anatomical locations affected

• Lab value documentation

• Treatment response patterns

The system flags incomplete documentation if key elements like duration, bilateral involvement, or morning stiffness timing are missing.