Myasthenia gravis is a neuromuscular disease characterized by weakness and rapid fatigue of voluntary muscles. It’s caused by a breakdown in the normal communication between nerves and muscles. In most cases, the muscles around the eyes tend to be affected first, causing the eyelids to droop. Patients may experience double vision, drooping eyelids, weakness in the arms and legs and difficulty in chewing, swallowing, speaking, and breathing. Even though this disease can affect people of any age, it’s more common in women younger than 40 and men older than 60 years. If left untreated, this condition can lead to serious complications such as – breathing problems, lupus, rheumatoid arthritis and thyroid problems. There’s no cure for myasthenia gravis, but immune-suppressants or cholinesterase inhibitors can help control symptoms. Physicians’ practices dealing with patients suffering from myasthenia gravis need to know the ICD-10 codes to report this condition correctly. Medical billing services from a reputable medical billing company help in accurate and timely claim filing for appropriate reimbursement.
Reports suggest that the condition affects up to 14 to 20 people in every 100,000, or between 36,000 and 60,000 people in the United States. Although this auto immune disorder can affect any of the muscles that you control voluntarily, certain muscle groups like eye muscles, face and throat muscles, and neck and limb muscles are more commonly affected than others. Related symptoms include ptosis, diplopia, (which may be horizontal or vertical), difficulty swallowing/chewing, changing facial expressions and difficulty in speaking. Generally, in about 10 percent of patients limb weakness may be the initial symptoms. The arm and leg muscles may weaken, affecting activities such as lifting or walking. However, when limb muscles are involved, other muscles also tend to be affected, such as that of the throat, eyes, or face.
What Causes Myasthenia Gravis (MG)?
MG is an autoimmune disorder which develops when your immune system attacks your own body tissues and destroys bacteria, toxins, or viruses. In a person with an autoimmune disease, antibodies circulate in the blood and block or destroy muscle receptor cells, resulting in fewer available muscle fibers. As a result, the muscles cannot contract properly, and they easily become tired and weak.
The exact cause of MG is not known, but the thymus gland (located in the upper chest), appears to play a prominent role. Reports suggest that a large number of adult patients with MG have an abnormally large thymus gland. It is estimated that 1 in 10 patients with MG have a benign tumor in the thymus gland. Other related causes include – genetics, usage of medications (beta blockers, calcium channel blockers, quinine and antibiotics), fatigue and stress.
Treatment Modalities for this Autoimmune Disorder
As part of the diagnosis, physicians will review patient symptoms and medical history and conduct a detailed physical examination. Physicians will conduct a wide range of tests such as – edrophonium test, ice pack test (placing a bag filled with ice on your eyelid to analyze droopy eyelids), repetitive nerve stimulation, pulmonary function tests, single-fiber electromyography (EMG) and blood analysis to confirm a diagnosis of MG. Physicians may also check neurological health by testing – reflexes, muscle strength, muscle tone, senses of touch and sight, coordination and balance. In addition, imaging tests like CT scan or MRI scan will be done to check if there is a tumor or other abnormality in your thymus.
Choice of treatment modalities will depend on several factors like patient age, severity of disease and how fast it’s progressing. The right combination of medications and intravenous therapy will be used to treat a sudden worsening of symptoms. Medications include – Cholinesterase inhibitors, corticosteroids and immune-suppressants. Therapies include – plasmapheresis, intravenous immunoglobulin (IVIg) and monoclonal antibody. In some cases, people with MG will have a tumor in their thymus gland. Physicians will surgically remove your thymus gland (thymectomy). Thymectomy can be performed as an open surgery or as a minimally invasive surgery. Treatment procedures and other tests performed by physicians must be carefully documented using the correct medical codes. Medical billing and coding outsourcing services provided by established medical billing companies can help physicians use the correct codes for their billing purposes.
ICD-10 codes for diagnosing MG include –
- G70 – Myasthenia gravis and other myoneural disorders
- G70.0 – Myasthenia gravis
- G70.00 – Myasthenia gravis, without (acute) exacerbation
- G70.01 – Myasthenia gravis, with (acute) exacerbation
- G70.1 – Toxic myoneural disorders
- G70.2 – Congenital and developmental myasthenia
Coping with myasthenia gravis can be difficult. However, a person can take adequate preventive steps to stop flare-up of symptoms or prevent them from developing complications. Preventive steps include – practicing careful hygiene to avoid infections, avoiding extreme temperatures and effective stress management.
To increase awareness of this autoimmune disease, the month of June is observed as the annual “Myasthenia Gravis (MG) Awareness Month”. Sponsored by the Myasthenia Gravis Foundation of America, Inc. (MGFA), this nationwide movement aims to educate people regarding the often misunderstood and under-diagnosed Myasthenia Gravis (MG) and its related symptoms and risk factors.
Holding a CPC certification from the American Academy of Professional Coders (AAPC), Natalie is a seasoned professional actively managing medical billing, medical coding, verification, and authorization services at OSI.