Jill McLaughlin
Senior Member
- Messages
- 196
ICD codes determine the diagnosis. We have recognized "It's
the name, stupid" and even "It's the definition, stupid." But
perhaps it should be "It's the diagnosis, stupid."
They all come into play, especially for advocacy. The name
sets the public awareness scene. The definition is
most important for research purposes to define a reliable
and representative patient cohort. The diagnosis is for the
clinical setting.
More importantly, they all have to match and be used specifically
and consistently with the same terminology and meanings. This
is where things have spun out of control and lost the plot as terms
all used differently or to mean different things.
For practical purpose, the ICD code determines the diagnosis.
ICD codes are beyond obscure codes used for billing purposes
or gathering statistics. With the overreach of electronic records,
the code IS the diagnosis that is in your record and follows you.
The ICD codes are the diagnosis, but do NOT determine what that
diagnosis actually is (which is what the disease definition does).
This is where the Coalition 4 ME/CFS proposal to change the
ICD codes fails to do what they say they want or what
claim it will; in fact it will do the opposite.
Changing the code to neurological will not make a difference.
It will still be a fatigue syndrome diagnosis of exclusion. CFS
does not define or describe a neurological illness so fudging
the codes will not help. The code will not override the definition.
However, the information that the Coalition 4 ME/CFS are giving
to the patient community seems to be misleading and deceptive.
They claim that their recommendations to NCHS will not affect
ME and state that it is only to reclassify CFS as neurological. But
their actual recommendation to NCHS was to classify CFS
to the same ICD code as ME at G93.3, which will combine them
both under a single code (see info below).
To change the code for CFS to the same code as ME will only
make them the same (diagnosis) and will be viewed as
synonymous terms. Adding the term ME will still not change
what it is. True ME will not exist. The ME-ICC will be for
naught, and this proposal does the opposite of what the
ICC calls for.
This clearly reflects their intention for ME=CFS=ME/CFS which
they have promoted and advertised all along. Hint: this is what
Wessely does: it allows him to study fatigue and pretend
to be studying ME
ME is not a fatigue syndrome. This proposal would deprive
ME patients of their rightful diagnosis by keeping it officially
as and connected to CFS.
ME is coded correctly as it has been for 40 years and should
remain as is and not be changed or subdivided. CFS is coded
correctly as is to fit the current definition.
Those with ME should oppose the changes put forth by the
Coalition 4 ME/CFS.
Contact:
NCHS review committee: nchsicd9CM@cdc.gov
and
Donna Pickett, RHIA, MPH
Medical Classification Administrator
National Center for Health Statistics
email: dfp4@cdc.gov
November 18, 2011 is the deadline for receipt of
public comments on proposed code revisions
discussed at the September 14, 2011 ICD
Coordination and Maintenance Committee meeting.
Jill McLaughlin
=============
The Coalition 4 ME/CFS proposal, summary, FAQ etc. say that it is
only to reclassify CFS as neurological:
http://coalition4mecfs.org/
NCHS report states that the Coalition 4 ME/CFS recommended that
CFS be added as an inclusion term along with ME under code G93.3.
http://www.cdc.gov/nchs/data/icd9/TopicpacketforSept2011a.pdf
*The Coalition 4 ME/CFS has said that there were doctors or medical
professionals involved or who supported this proposal. Yet the only
basis of support I have actually seen them produce as evidence are
CFSAC recommendations. But again, the only CFSAC recommendations
I have seen are to change CFS to a neurological code, but not code it to
ME *as they have actually done.
the name, stupid" and even "It's the definition, stupid." But
perhaps it should be "It's the diagnosis, stupid."
They all come into play, especially for advocacy. The name
sets the public awareness scene. The definition is
most important for research purposes to define a reliable
and representative patient cohort. The diagnosis is for the
clinical setting.
More importantly, they all have to match and be used specifically
and consistently with the same terminology and meanings. This
is where things have spun out of control and lost the plot as terms
all used differently or to mean different things.
For practical purpose, the ICD code determines the diagnosis.
ICD codes are beyond obscure codes used for billing purposes
or gathering statistics. With the overreach of electronic records,
the code IS the diagnosis that is in your record and follows you.
The ICD codes are the diagnosis, but do NOT determine what that
diagnosis actually is (which is what the disease definition does).
This is where the Coalition 4 ME/CFS proposal to change the
ICD codes fails to do what they say they want or what
claim it will; in fact it will do the opposite.
Changing the code to neurological will not make a difference.
It will still be a fatigue syndrome diagnosis of exclusion. CFS
does not define or describe a neurological illness so fudging
the codes will not help. The code will not override the definition.
However, the information that the Coalition 4 ME/CFS are giving
to the patient community seems to be misleading and deceptive.
They claim that their recommendations to NCHS will not affect
ME and state that it is only to reclassify CFS as neurological. But
their actual recommendation to NCHS was to classify CFS
to the same ICD code as ME at G93.3, which will combine them
both under a single code (see info below).
To change the code for CFS to the same code as ME will only
make them the same (diagnosis) and will be viewed as
synonymous terms. Adding the term ME will still not change
what it is. True ME will not exist. The ME-ICC will be for
naught, and this proposal does the opposite of what the
ICC calls for.
This clearly reflects their intention for ME=CFS=ME/CFS which
they have promoted and advertised all along. Hint: this is what
Wessely does: it allows him to study fatigue and pretend
to be studying ME
ME is not a fatigue syndrome. This proposal would deprive
ME patients of their rightful diagnosis by keeping it officially
as and connected to CFS.
ME is coded correctly as it has been for 40 years and should
remain as is and not be changed or subdivided. CFS is coded
correctly as is to fit the current definition.
Those with ME should oppose the changes put forth by the
Coalition 4 ME/CFS.
Contact:
NCHS review committee: nchsicd9CM@cdc.gov
and
Donna Pickett, RHIA, MPH
Medical Classification Administrator
National Center for Health Statistics
email: dfp4@cdc.gov
November 18, 2011 is the deadline for receipt of
public comments on proposed code revisions
discussed at the September 14, 2011 ICD
Coordination and Maintenance Committee meeting.
Jill McLaughlin
=============
The Coalition 4 ME/CFS proposal, summary, FAQ etc. say that it is
only to reclassify CFS as neurological:
http://coalition4mecfs.org/
NCHS report states that the Coalition 4 ME/CFS recommended that
CFS be added as an inclusion term along with ME under code G93.3.
http://www.cdc.gov/nchs/data/icd9/TopicpacketforSept2011a.pdf
*The Coalition 4 ME/CFS has said that there were doctors or medical
professionals involved or who supported this proposal. Yet the only
basis of support I have actually seen them produce as evidence are
CFSAC recommendations. But again, the only CFSAC recommendations
I have seen are to change CFS to a neurological code, but not code it to
ME *as they have actually done.