Medical Coding Update: Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) has a Distinct ICD-10 Code, G93.32
The research and clinical care of ME/CFS achieved an important milestone on October 1, 2022, with the update to ICD-10-CM (the International Classification of Diseases modified for use in the United States). The ICD-10-CM codes now include a specific code for myalgic encephalomyelitis/chronic fatigue syndrome, G93.32. The code applies to “myalgic encephalomyelitis/chronic fatigue syndrome,” “chronic fatigue syndrome,” and “myalgic encephalomyelitis.” Providers can now select G93.32 as a diagnostic code for ME/CFS. The update also directs coders to use the code U09.9 for post-COVID condition when appropriate, making it clearer when ME/CFS occurs following SARS CoV-2 infection.
Prior versions of ICD-10-M placed chronic fatigue syndrome in the non-specific “chronic fatigue, unspecified” R53.82. This brought much confusion to healthcare providers, patients, and researchers because ME/CFS was grouped with all types of unspecified chronic fatigue. The new code will make it easier for healthcare providers to bill and get reimbursed for ME/CFS-related care as it enables documentation of ME/CFS in medical records. The new release also modifies the description of tabular listing code G93.3 to encompass both viral and non-viral causes.
CDC’s National Center for Health Statistics (NCHS) made the recommendations based on a proposal from seven ME/CFS patient advocate organizations to allow accurate coding for understanding ME/CFS using medical records. Potential impacts include more precise tracking of ME/CFS morbidity and mortality and ME/CFS- related healthcare utilization. The new code will not prevent misdiagnosis or under-diagnosis of patients and will not correct for past coding classifications. However, highlighting the new code will raise awareness of ME/CFS among healthcare providers.
For more information and to see a comprehensive list of the ICD-10-CM codes, please visit: Comprehensive Listing ICD-10-CM Files