Tina
Well-Known Member
I came across this article on masscfids.com about illness codes. I guess what doctors use to bill insurance companies. It made me stop and think...I have no idea what code my doctor has on file for me. I have been told I have CFS. That is the extent of it. (You have to realize that I am an active duty military wife so we get all medical care at the local hospital and there is no paperwork)
Does it make sense to find out and if so does it make sense to ask for the G93.3 code? What are your thoughts?
On January 24, 2016, the author writes:
It is a bit confusing, but the author breaks down four different codes:
R53.82: Chronic Fatigue Syndrome, the name most used to identify the illness, will be placed after October 1, 2014 in the vague "orphan" category: Chapter 18, "Symptoms, signs, and abnormal clinical and laboratory findings, not elsewhere classified"
780.71: The code for CFS is 780.71. Because most doctors and insurance companies in the U.S. know ME/CFS as Chronic Fatigue Syndrome, the illness has been frequently coded as 780.71. It places CFS in the vague category: "General Symptoms", in the Chapter: "Symptoms, Signs, and Ill-Defined Conditions"
323.9: In the current ICD-9-CM, ME/CFS is classified as a nervous/organ system disease in Chapter 6, "Diseases of the Nervous System and Sense Organs" (320-389), under subheading 320-326 "Inflammatory Diseases of the Central Nervous System". The Tabular Listing gives the specific code as 323.9: "Unspecified cause of encephalitis, myelitis, and encephalomyelitis." The associated Index document lists "Encephalomyelitis (chronic) (granulomatous) (hemorrhagic necrotizing, acute) (myalgic, benign) (see also Encephalomyelitis)" also coded as 323.9.
G93.3: However, less well known by physicians is the placement both in the current ICD-9-CM and the new, revised code ICD-10-CM of (b)ME and Postviral Fatigue Syndrome (PVFS) under Diseases of the Nervous System. In the ICD-10-CM, (b)ME and PVFS will be coded in Chapter 6 "Diseases of the Nervous System", in the subcategory G93 "Other Disorders of the Brain". G93.3 is the actual code for (b)ME and PVFS
Ultimately the author states:
Full article here: https://www.masscfids.org/resource-...s-codes-perpetuate-medical-ignorance-of-mecfs
Does it make sense to find out and if so does it make sense to ask for the G93.3 code? What are your thoughts?
On January 24, 2016, the author writes:
After more than thirty years, U.S. Centers for Disease Control and Prevention (CDC) is adopting an updated classification code for illnesses and diseases. This new code, the International Classification of Diseases-10-Clinical Modification (ICD-10-CM) will supersede the current U.S. code, the ICD-9-CM. Implementation of the new code is scheduled for October 1, 2014.
To understand the differences in these names and their importance to patients, a little history is in order. The devastating, flu-like illness with neurological and multi-systemic effects was identified as benign Myalgic Encephalomyelitis (bME) and Postviral Fatigue Syndrome (PVFS) by Dr. Melvin Ramsay and other doctors in Europe in the 1950s and 1960s. "Myalgic" means muscle pain and "encephalomyelitis" means inflammation or infection of the brain. Since the 1990s many patients and doctors in England, other European countries, Canada, Australia and New Zealand have used the term ME as the name for the illness. (When ME was first defined in England in the 1950s the word "benign" was attached for a short time; later the illness became simply ME.)
It is a bit confusing, but the author breaks down four different codes:
R53.82: Chronic Fatigue Syndrome, the name most used to identify the illness, will be placed after October 1, 2014 in the vague "orphan" category: Chapter 18, "Symptoms, signs, and abnormal clinical and laboratory findings, not elsewhere classified"
780.71: The code for CFS is 780.71. Because most doctors and insurance companies in the U.S. know ME/CFS as Chronic Fatigue Syndrome, the illness has been frequently coded as 780.71. It places CFS in the vague category: "General Symptoms", in the Chapter: "Symptoms, Signs, and Ill-Defined Conditions"
323.9: In the current ICD-9-CM, ME/CFS is classified as a nervous/organ system disease in Chapter 6, "Diseases of the Nervous System and Sense Organs" (320-389), under subheading 320-326 "Inflammatory Diseases of the Central Nervous System". The Tabular Listing gives the specific code as 323.9: "Unspecified cause of encephalitis, myelitis, and encephalomyelitis." The associated Index document lists "Encephalomyelitis (chronic) (granulomatous) (hemorrhagic necrotizing, acute) (myalgic, benign) (see also Encephalomyelitis)" also coded as 323.9.
G93.3: However, less well known by physicians is the placement both in the current ICD-9-CM and the new, revised code ICD-10-CM of (b)ME and Postviral Fatigue Syndrome (PVFS) under Diseases of the Nervous System. In the ICD-10-CM, (b)ME and PVFS will be coded in Chapter 6 "Diseases of the Nervous System", in the subcategory G93 "Other Disorders of the Brain". G93.3 is the actual code for (b)ME and PVFS
Ultimately the author states:
Obviously, most patients with ME/CFS will be far better served if they are coded as 323.9 under the current code and under G93.3 when the new code takes effect.
Full article here: https://www.masscfids.org/resource-...s-codes-perpetuate-medical-ignorance-of-mecfs