Chronic Fatigue Syndrome
AHIMA recommends that chronic fatigue syndrome be given a unique code and not be classified to code R53.82, Chronic fatigue, unspecified. However, we do not believe this condition belongs in subcategory G93.3, Postviral fatigue syndrome, although we recognize this is where the international version of ICD-10 has classified chronic fatigue syndrome. As stated in the background material provided with the code proposal, the cause or causes of chronic fatigue syndrome remain unknown. Therefore, it would not be appropriate to classify this condition as postviral.
Given the lack of clinical consensus on whether chronic fatigue syndrome and myalgic encephalomyelitis are the same or different conditions, and the fact that these terms are sometimes used interchangeably in medical record documentation, we do not believe it is appropriate to create a unique code for myalgic encephalomyelitis. Until such time as there is consensus on a case definition that classifies chronic fatigue syndrome and myalgic encephalomyelitis as separate and distinct conditions, myalgic encephalomyelitis should be indexed to (and listed as an inclusion term under) the code for chronic fatigue syndrome. At this time, separate codes would not produce good data on which to base research on these conditions, as overlaps between the conditions and interchangeable use of terms would result in a mix of both conditions being assigned to both codes.
Although chronic fatigue syndrome does not represent a new disease, AHIMA recommends that consideration be given to creating a new code for this condition during the code freeze. We believe that since chronic fatigue syndrome has had a unique code in ICD-9-CM for some time, the lack of a unique code in ICD-10-CM should be considered an error or oversight.
