Current RMA Instruments
| Reasonable Hypothesis SOP | 107 of 2021 |
| Balance of Probabilities SOP | 108 of 2021 |
Changes from previous Instruments
ICD Coding
- ICD-9-CM Codes: 729.1
- ICD-10-AM Codes: M79.7
Brief description
Fibromyalgia is a controversial disorder, with no established organic basis. It manifests with chronic widespread musculoskeletal pain that is often accompanied by fatigue, sleep disturbance, cognitive disturbance, psychiatric symptoms, and other somatic symptoms. In this disorder there is no objective evidence of local pathology at the pain sites, but a central pain sensitisation mechanism may be responsible.
Confirming the diagnosis
Fibromyalgia is a clinical diagnosis, based on duration of symptoms, widespread pain in multiple sites, associated features, and the exclusion of other conditions that could account for the symptoms. The clinical criteria contained in the SOP defintion need to be met for the SOP to be applied. There are no confirmatory laboratory or other tests.
The relevant medical specialist is a rheumatologist.
Additional diagnoses covered by SOP
- Nil
Conditions excluded from SOP
- Symptom or manifestation of psychiatric conditions such as depression.
- Conversion disorder#
- Chronic fatigue syndrome*
- Somatic symptom disorder*
- Complex regional pain syndrome*
* Another SOP applies
# Non-SOP condition
Clinical onset
Clinical onset will be based on when relevant symptoms first developed.
Clinical worsening
The only SOP worsening factor is for inability to obtain appropriate clinical management. The condition is difficult to treat. Some people have improvement in symptoms with a multidisciplinary treatment approach, but some people are unresponsive to available treatment options.