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what are we doing about the ICD-10-CM?

WillowJ

คภภเє ɠรค๓թєl
Messages
4,940
Location
WA, USA
In the US's Clinical Modifications, CFS is broken into two parts, one where the WHO has it with ME under neurological disorders and postviral fatigue syndrome, and one where the US is accustomed to having it under vague symptoms, CFS "not otherwise specified."

What are we doing about this and what can we be doing?

Any health professionals here that can say whether a diagnostic category can be stricken from the code after it's been voted on? Evidently implementation was delayed because no one wanted to learn the entire new code between now and October, so we might have some time for this.
 

Marty

Senior Member
Messages
118
what can we be doing?

I read yesterday about a big conference of shrinks in Europe who are trying to make all medically "unsupported" illnesses out to be mental, complete with many published papers. They were trying to clean up all these "unsupportable" medical costs. It was one of the most depressing things I've ever read and shows that this classification issue is a big thing.
 

WillowJ

คภภเє ɠรค๓թєl
Messages
4,940
Location
WA, USA
yeah, I know about the "MUS" conference, too. that's depressing for sure. and yes, I do see how it ties in to the vague classification.

we need to do something on both counts
 

Marty

Senior Member
Messages
118
I've always thought that what makes our docs different from others is that they have the humility to believe their patients.
 

Dx Revision Watch

Suzy Chapman Owner of Dx Revision Watch
Messages
3,061
Location
UK
Links for ICD-10-CM documents, codings and commentary

@ Willow

As a UK resident, I don't involve myself in the politics and advocacy around the current proposals for the coding of CFS, PVFS and ME in the forthcoming US specific "Clinical Modification", ICD-10-CM.

But I maintain a site called Dx Revision Watch which does carry some information about ICD-10-CM, in order to clarify between the proposed codings for ICD-10-CM, current codings in ICD-10 and proposed codings for the forthcoming ICD-11, which is anticipated in 2014+.

There are also comparisons between the proposed codings for ICD-10-CM and the existing codings for CFS, PVFS and ME in a couple of other country modifications, namely Canada (ICD-10-CA) and Germany (ICD-10-GM).

So below, I'm posting a compilation of information which I'm hoping will be of interest to readers who were not following a previous thread on ICD-10-CM.


There was a previous thread on these forums with a lot of discussion on ICD-10-CM started in April 21, 2010, here:

http://forums.aboutmecfs.org/showthread.php?4510-ME-and-cfs-to-be-classified-as-seperate-illnesses

ME and cfs to be classified as seperate illnesses

-----------------------

On my own site, towards the end of this page (which is Page 2 of two sub pages on ICD codings) I have set out the current proposed codings for ICD-10-CM for CFS in Chapter 18 (the R codes) and PVFS and ME in Chapter 6 (the G codes) as they are set out in the ICD-10-CM Tabular List:

http://dxrevisionwatch.wordpress.com

http://dxrevisionwatch.wordpress.com/icd-11-me-cfs/2/

Forthcoming US Clinical Modification ICD-10-CM

Current proposals for the US Clinical Modification ICD-10-CM, scheduled for implementation in October 2013, propose classifying Chronic fatigue syndrome in ICD-10-CM Chapter 18 at R53.82 etc.

-----------------------

In June, last year, I also published this posting on my own site which further clarifies between ICD-10 and the proposed codings for ICD-10-CM:

US Clinical Modification ICD-10-CM

http://wp.me/pKrrB-Ka

It also includes this link for an archive CDC document that sets out the history of codings for these three terms up to March 2001 and shows that, at that point, all three were proposed to be placed in Chapter 6 (the G codes).

CDC document: A Summary of Chronic Fatigue Syndrome and Its Classification in the International Classification of Diseases, March 2001 proposals:

http://www.co-cure.org/ICD_code.pdf

------------------------

The URL for the CDC site for information on ICD-10-CM and from where documents like the latest version of the Tabular List can be downloaded is:

http://www.cdc.gov/nchs/icd/icd10cm.htm

See heading: ICD-10-CM Files - 2011 release

The CDC site was updated in December and new versions of the documents were added. If you click on any of the links for 2011, it will take you to these files:

12/20/2010 09:05AM 690,231 DiagnosisGEMs_2011.zip
12/20/2010 07:40AM 14,131,267 icd10_cm_pdf.zip
12/20/2010 07:40AM 2,000,540 icd10cm_addenda_2010_2011.zip
12/20/2010 07:40AM 2,046,858 icd10cm_xml_2011.zip
12/20/2010 07:40AM 616,190 ICD10CMdescriptions_2011.zip



It's a little difficult to see which files you might want. I already had a copy of the 2010 version for the proposed Tabular List but also wanted the most recent version. So I downloaded the largest file, which is this one:

14,131,267 icd10_cm_pdf.zip

This unZips to a file which contains a number of PDFs and the Tabular List and Index for 2011 are within this file. It would have been so much easier if the PDFs could have been uploaded separately!

The Tabular List is around 7MB unZipped and the Index around 4.7MB.

------------------------

If you go to this site:

http://www.cms.gov/ICD10/12_2010_ICD_10_CM.asp#TopOfPage

The 2010 versions of the various documents are available as unZipped PDFs and much easier to locate what you are looking for. But the page does not yet appear to have been updated with the latest versions for 2011.

------------------------

I have several URLs for sources for the information that the ICD-10-CM is proposed to be frozen by October 1, 2011 for example:

CMS, CDC call for ICD-9 and ICD-10 code freeze

http://icd10watch.com/headline/cms-cdc-call-icd-9-and-icd-10-code-freeze

"CMS, the Centers for Medicare and Medicaid Services, along with CDC, the Centers for Disease Control and Prevention, proposed that both ICD-9-CM and ICD-10-CM/PCS code sets be frozen two years before the compliance deadline.

"What that means: As of October 1, 2011, only limited updates would be instituted into the code sets so that providers, payers, clearinghouses, and health IT vendors, will not have to simultaneously keep pace with code updates while also reconfiguring their existing systems for ICD-10-CM/PCS."
Source: ICD10 Watch.com

(That site with a similar name has no connection with my own site.)

----------------

Finally, a couple of recent Co-Cure mailings around ICD-10-CM codings from US advocates:


From Mary Schweitzer

Sent: Wednesday, January 26, 2011 8:42 PM
Subject: Re: [CO-CURE] ACT, RES, NOT: ME/CFS State of the Knowledge Workshop


To clarify a few things:

ME/CFS is the name used in the Canadian Consensus Criteria, so it does have a formal usage.

The name was chosen in 2003 to reflect the placement of both ME and CFS in ICD-10 under the chapter on neurology at G93.3. Many patient advocates believe the Canadian Consensus Critera represents the best current definition in use.

In the US, myalgic encephalomyelitis was never used. When British researchers began using M.E., the US instead used Epidemic Neuromyesthenia. However, Alex Shelekov, the national expert on epidemic neuromyesthenia, sided with those at the 1988 Holmes meeting who said the cluster outbreaks were M.E. That was not even included in a footnote, but in a companion article the same year, the late Stephen Straus wrote that CFS was also once known as epidemic neuromyesthenia and, without using the term M.E., nevertheless referenced the two McAvedy and Beard articles suggesting M.E. was really mass hysteria, using them to lend authority to his assertion that researchers knew CFS patients actually had mental problems.

To introduce the term ME to the US medical establishment, many advocates - dating back to the late 1990s - had suggested the use of ME/CFS and ultimately dropping the CFS part. I suggested it myself when presenting at a special name change session on the AACFS program in 1998, but I was not the only one.

In 1998 CDC removed 323.9, the designation for M.E., from ICD-9-CM. Doctors in the U.S. have to use those codes for insurance reimbursement, so that was tantamount to rendering the disease nonexistent. As it was, most doctors in the US refused to give that diagnosis when asked. Now it required a second diagnosis for reimbursement.

After patients began clamoring for the adoption of the Canadian Consensus Criteria that linked M.E. and CFS, CDC added a statement to ONE of their websites to the effect that the two were not the same thing. I thought at the time it was not a recognition of M.E. (because you will find nothing on M.E. anywhere else at CDC), but an effort to negate the movement to adopt the Canadian Criteria.

Personally, I was surprised and delighted that the CFSAC recommended the use of the term ME/CFS because it would place CFS in G93.3 in ICD-10-CM, which is still not scheduled for adoption until at least 2013. The rest of the world is looking on to ICD-11, but the US is still on ICD-9.

The CFSAC is an advisory committee to the Secretary of Health and Human Services, who oversees both CDC and NIH. It is well within their purview to recommend the use of ME/CFS, and well within the purview of NIH to follow that recommendation in an exploratory workshop on the state of the knowledge, for now.

Finally, while I fully appreciate why patients in nations that have a history of M.E. would like to get rid of CFS entirely and not see it paired with M.E., please understand that doing so in the US means that CFS, the only name used in the vast majority of the medical establishment in the US (who never heard of M.E.), will be placed in R53 under "vague signs and symptoms" - not G93.3, in neurology, in ICD-10-CM.

Mary Schweitzer

----------------------

and from Kelly Latta:


Sent: Friday, January 21, 2011 10:54 PM
Subject: [CO-CURE] NOT: DHHS study At Risk: Pre-Existing Conditions Could Affect 1 in 2 Americans:


Note: The question remains, will CFS become an uninsurable condition?
Although CFS is not on the current HHS list, many other neurological
and virally-induced diseases are. And then it gets complicated.

Insurance billing and diagnosis categorization are done through the
World Health Organization's International Classification of Diseases
(ICD).

Currently CFS is listed in the ICD-9 CM under R53.82 a classification
which is used only in the United States and falls under the purview of
the CDC. The initials CM stand for clinical modification.

With only a few other exceptions, other countries are required to use
the ICD-10 G93.3 classification for myalgic encephalomyelitis which is
the tabular listing with post viral fatigue syndrome and CFS in the
alphabetical listing.

In 2013 the United States will switch over to the ICD-10 CM. As it
stands now, CFS will remain in the malaise and fatigue category of
generalized symptoms whereas post viral fatigue syndrome and myalgic
encephalomyelitis will be listed under G93.3.

The currently proposed tabular ICD-10 CM index on page 264 states it thusly:

G93.3
Postviral fatigue syndrome
Benign myalgic encephalomyelitis
Excludes1:
chronic fatigue syndrome NOS (R53.82)


Something to note may be that the amalgamation of ME/CFS as is now
used by the NIH doesn't technically exist although for classification
purposes the international WHO may consider the three terms synonymous
(the literature is unclear here) although the U.S. CDC clearly does
not.

The resulting misclassification in the doctor's office for doctors
unfamiliar with the definitions could ultimately result in incomplete
reporting on CFS- related deaths as well as inaccurate epidemiology -
two areas for which the ICD was initially created to provide such
statististics. As noted in previous posts the Somatic Disorders DSM V
working group's proposed CSSD, and particularly the new SSSD
categories would benefit from CFS remaining in the R Chapter as this
implies that the symptoms are medically unexplained.

Further information on the ICD-10 can be found here:
http://www.cdc.gov/nchs/icd/icd10cm.htm#10update


At Risk: Pre-Existing Conditions Could Affect 1 in 2 Americans:

129 Million People Could Be Denied Affordable Coverage Without Health Reform

Introduction

According to a new analysis by the Department of Health and Human
Services, 50 to 129 million (19 to 50 percent of) non-elderly
Americans have some type of pre-existing health condition. Up to one
in five non-elderly Americans with a pre-existing condition 25
million individuals is uninsured. Under the Affordable Care Act
starting in 2014, these Americans cannot be denied coverage, be
charged significantly higher premiums, be subjected to an extended
waiting period, or have their benefits curtailed by insurance
companies.

As many as 82 million Americans with employer-based coverage have a
pre-existing condition, ranging from life-threatening illnesses like
cancer to chronic conditions like diabetes, asthma, or heart disease.
Without the Affordable Care Act, such conditions limit the ability to
obtain affordable health insurance if they become self-employed, take
a job with a company that does not offer coverage, or experience a
change in life circumstance, such as divorce, retirement, or moving to
a different state. Older Americans between ages 55 and 64 are at
particular risk: 48 to 86 percent of people in that age bracket have
some type of pre-existing condition. And 15 to 30 percent of people
in perfectly good health today are likely to develop a pre-existing
condition over the next eight years, severely limiting their choices
without the protections of the Affordable Care Act.

For the full DHHS study:
http://www.healthcare.gov/center/reports/preexisting.html

-----------------

Hope these links may be of interest to those coming fresh to this issue.

Suzy
 

Dx Revision Watch

Suzy Chapman Owner of Dx Revision Watch
Messages
3,061
Location
UK
ICD-10-CM Chapter 5: F45 -F48: Somatoform disorders

For comparison with current proposals for DSM-5 Somatoform disorders, these are the proposals for ICD-10-CM (version for 2011) Somatoform Disorders categories:

ICD-10-CM TABULAR LIST of DISEASES and INJURIES

ICD-10-CM Chapter 5: F45 -F48: Somatoform disorders

Page 218

F45
Somatoform disorders
Excludes2:
dissociative and conversion disorders (F44.-)
factitious disorders (F68.1-)
hair-plucking (F63.3)
lalling (F80.0)
lisping (F80.0)
malingering [conscious simulation] (Z76.5)
nail-biting (F98.8)
psychological or behavioral factors associated with disorders or diseases classified elsewhere (F54)
sexual dysfunction, not due to a substance or known physiological condition (F52.-)
thumb-sucking (F98.8)
tic disorders (in childhood and adolescence) (F95.-)
Tourette's syndrome (F95.2)
trichotillomania (F63.3)

F45.0
Somatization disorder

Briquet's disorder
Multiple psychosomatic disorder

F45.1
Undifferentiated somatoform disorder

Undifferentiated psychosomatic disorder

F45.2
Hypochondriacal disorders

Excludes2:
delusional dysmorphophobia (F22)
fixed delusions about bodily functions or shape (F22)

F45.20
Hypochondriacal disorder, unspecified


F45.21
Hypochondriasis

Hypochondriacal neurosis

F45.22
Body dysmorphic disorder


Dysmorphophobia (nondelusional)
Nosophobia

F45.29
Other hypochondriacal disorders


F45.4
Pain disorders related to psychological factors

Excludes1:
pain NOS (R52)

F45.41
Pain disorder exclusively related to psychological factors

Somatoform pain disorder (persistent)

F45.42
Pain disorder with related psychological factors

Code also
associated acute or chronic pain (G89.-)

F45.8
Other somatoform disorders

Psychogenic dysmenorrhea
Psychogenic dysphagia, including 'globus hystericus'
Psychogenic pruritus
Psychogenic torticollis
Somatoform autonomic dysfunction
Teeth grinding
Excludes1:
sleep related teeth grinding (G47.63)

F45.9
Somatoform disorder, unspecified

Psychosomatic disorder NOS

F48
Other nonpsychotic mental disorders


F48.1
Depersonalization-derealization syndrome


F48.8
Other specified nonpsychotic mental disorders

Dhat syndrome
Neurasthenia
Occupational neurosis, including writer's cramp
Psychasthenia
Psychasthenic neurosis
Psychogenic syncope

F48.9
Nonpsychotic mental disorder, unspecified

Neurosis NOS
 

Dx Revision Watch

Suzy Chapman Owner of Dx Revision Watch
Messages
3,061
Location
UK
If the previous posters are referring to the next annual conference of the EACLPP that I flagged up in another thread, it's a Consultation-Liaison and Psychiatry and Psychosomatics conference and not specific to MUS:

XIV Annual Scientific Meeting European Association for Consultation-Liaison
Psychiatry and Psychosomatics (EACLPP)
Budapest, Hungary
June 30th - July 2nd 2011


http://forums.aboutmecfs.org/showth...-Syndrome-quot&p=152657&viewfull=1#post152657


The Journal of Psychosomatic Research is the official organ of the EACLPP. The J Psychosoma Res co-editors are Francis Creed and James Levenson who are both members of the DSM-5 SSD Work Group; the journal has been used as a vehicle for editorials on the deliberations of the DSM-5 SSD Work Group and for publishing papers and commentary around and feeding into the revision of the Somatoform Disorders section of DSM-IV.
 
Messages
13,774
Thanks for that Suzy. And all the work you're doing on this. I've not really been able to keen up with it all, but it's great to have access to your updates.
 

Dx Revision Watch

Suzy Chapman Owner of Dx Revision Watch
Messages
3,061
Location
UK
Thanks, Esther,

I would have thought there might have been more interest in the issue of the proposed codings for ICD-10-CM with so many US folk on these forums.

Suzy
 

Marty

Senior Member
Messages
118
I would have thought there might have been more interest in the issue of the proposed codings for ICD-10-CM with so many US folk on these forums.

I'm positive there is interest, Suzy; but maybe others like me are confused. I thought ICD was international, and that the MUS conference impacted us all. We can't wrap our minds around long posts, but maybe you could give us a short summary of the issues? And exactly what is WHO and what relationship do they have to our classification?
 
Messages
13,774
Thanks, Esther,

I would have thought there might have been more interest in the issue of the proposed codings for ICD-10-CM with so many US folk on these forums.

Suzy

I think a lot of people find it difficult to take in all the info. I've been following your posts for a while, so can just about keep up, but for a lot of members I expect it's all just a bit confusing.

Maybe Cort or someone could put together a concise article at some point? ICD-10 for dummies. It just seems like new data's always coming, so it's never clear when the right time to write it would be.
 

justinreilly

Senior Member
Messages
2,498
Location
NYC (& RI)
I think a lot of people find it difficult to take in all the info. I've been following your posts for a while, so can just about keep up, but for a lot of members I expect it's all just a bit confusing.

Maybe Cort or someone could put together a concise article at some point? ICD-10 for dummies. It just seems like new data's always coming, so it's never clear when the right time to write it would be.

I agree. I have a hard time organizing in my mind all that data you present in your posts.

So, does anyone know whom to write or contact? And it sounds like it's already been adopted. do you think it will be worth it to make the effort now. this certainly is distressing that "CFS" is still in "vague symptoms and signs" and separated from ME!!
 

Dx Revision Watch

Suzy Chapman Owner of Dx Revision Watch
Messages
3,061
Location
UK
I'm positive there is interest, Suzy; but maybe others like me are confused. I thought ICD was international, and that the MUS conference impacted us all. We can't wrap our minds around long posts, but maybe you could give us a short summary of the issues? And exactly what is WHO and what relationship do they have to our classification?


Marty, the difference between the ICD-10 and ICD-10-CM has been covered on this site, in several threads, many times.

I have given a link to a previous thread on the issue of ICD-10-CM.

I have already given you a link to a post on my own site that sets out a clarification between the two.

It is this post:

US “Clinical Modification” ICD-10-CM

Shortlink Post #45: http://wp.me/pKrrB-Ka


The difference between the two are set out very clealy in that post.

Perhaps it would be helpful if you asked the mods to merge the two threads?

Suzy
 

Dx Revision Watch

Suzy Chapman Owner of Dx Revision Watch
Messages
3,061
Location
UK
I'm positive there is interest, Suzy; but maybe others like me are confused. I thought ICD was international, and that the MUS conference impacted us all. We can't wrap our minds around long posts, but maybe you could give us a short summary of the issues? And exactly what is WHO and what relationship do they have to our classification?

Marty, please read this post on my site:

US “Clinical Modification” ICD-10-CM

Shortlink Post #45: http://wp.me/pKrrB-Ka
 

Dx Revision Watch

Suzy Chapman Owner of Dx Revision Watch
Messages
3,061
Location
UK
Given that Cort is US and ICD-10-CM is an issue relevant to him and given that Cort has evidently got the time to promote the Lightning Process and "Abraham-Hicks" crap, I'm sure he'd be delighted to write you a Dummies Guide to ICD-10-CM.
 

Dx Revision Watch

Suzy Chapman Owner of Dx Revision Watch
Messages
3,061
Location
UK
Exit post

This will be my final post in this thread but also my final post on Phoenix Rising forums.

Since early 2009, I have been raising awareness in the UK and internationally around three discrete disease classification systems:

1] The revision of DSM-IV, which has international implications. DSM-5 is expected to be published in May 2013.

2] The revision of the WHO's ICD-10 which is used throughout the world by countries which have not been authorized by the WHO to develop their own Clinical Modification of ICD. ICD-11 is expected to be published in 2014-15. The US, Canada and Germany, plus a few other countries use their own Clinical Modifications of versions of ICD.

3] The proposals for the coding of CFS, PVFS and ME for the forthcoming ICD-10-CM. This is a Clinical Modification which is specific to the US. It is an adaptation of ICD-10 and will not be used outside the US. It is scheduled for implementation on 1 October 2013.

It is the US who is responsible for the proposals in ICD-10-CM - not the WHO, Geneva and the US will not be adopting ICD-11 in 2014+.


From the CDC website:

http://www.cdc.gov/nchs/icd/icd10cm.htm

"The National Center for Health Statistics (NCHS), the Federal agency responsible for use of the International Statistical Classification of Diseases and Related Health Problems, 10th revision (ICD-10) in the United States, has developed a clinical modification of the classification for morbidity purposes. The ICD-10 is used to code and classify mortality data from death certificates, having replaced ICD-9 for this purpose as of January 1, 1999. ICD-10-CM is planned as the replacement for ICD-9-CM, volumes 1 and 2.

"The ICD-10 is copyrighted by the World Health Organization (WHO), which owns and publishes the classification. WHO has authorized the development of an adaptation of ICD-10 for use in the United States for U.S. government purposes. As agreed, all modifications to the ICD-10 must conform to WHO conventions for the ICD. ICD-10-CM was developed following a thorough evaluation by a Technical Advisory Panel and extensive additional consultation with physician groups, clinical coders, and others to assure clinical accuracy and utility."


-----------------

As a UK resident, I do not get involved with the politics and advocacy around the proposals for ICD-10-CM but I do provide information on my website and clarifications between ICD-10, ICD-11 and ICD-10-CM.

Since November 2009, I have been posting information and updates relating to all three systems on Phoenix Rising forums, across a number of threads.

In late 2009, I set up my Dx Revision Watch website as a resource for information and updates on the development of all three classification publications.


The following applies only to ICD-10-CM which is US specific

I have already posted links where more information can be obtained - but briefly:

In 2001, proposals for ICD-10-CM had been that CFS, PVFS and ME would all be placed in Chapter 6 and coded at G93.3.

The current proposal is that CFS is placed in Chapter 18 (the R codes) with PVFS and ME in Chapter 6 (Neurological) at G93.3.

This is not new information. The issue of the placement of CFS in the R codes chapter of ICD-10-CM has been an issue for several years. It has been discussed on this forum and elsewhere. It has been raised at CFSAC meetings. It was raised at a CFSAC meeting, last year, by Dr Nancy Klimas and Dr Lenny Jason.

US advocates, like Mary Schweizter, Jean Harrison and Kelly Latta have posted about the issue on Co-Cure and other platforms.

It has been discussed at length in a previous thread on Phoenix Rising, though not recently, which is why I have commented on the apparent lack of current interest on Phoenix Rising.

This is the previous thread:

http://forums.aboutmecfs.org/showthread.php?4510-ME-and-cfs-to-be-classified-as-seperate-illnesses

ME and cfs to be classified as seperate illnesses


So, in order not to lose the considerable information and discussion that has already taken place on this forum, I suggest that the starter of this thread, Willow, gives consideration to asking the mods to combine the two threads. Otherwise folk are going to have to repeat information that has already been posted, rather than link to a previous post or posts where information or concerns or the history of this issue are already set out.

Back in late 2009/early 2010 one member of Phoenix Rising announced that they would be setting up a website which would present information around DSM-5 and ICD-10-CM from the US perspective but this was not followed through.

It has been suggested to me recently, that someone in the US could usefully create a site specifically for information on DSM-5 from the US perspective and on ICD-10-CM from the US perspective, as ICD-10-CM will not apply to other countries.

Perhaps someone would like to do that.

With the beta draft of DSM-5 due to be released in May/June this year for a brief period for public review and comment and the "freezing" of ICD-10-CM codings projected, apparently, for October 2011, this would need to be put in hand very soon.

As far as I know, forum owner Cort has not published anything on the DSM-5 or ICD-10-CM issues. I find this quite remarkable given the implications for both classification systems for US CFS and ME patients.

But then I find it quite remarkable that Cort gives platforms for US Lightning Process practitioners and has been sucked into "Abraham-Hicks".

ICD-10-CM is a US issue and you need to be looking to your US advocates for advice.

As Mary Schweizter has said at the end of her Co-Cure mailing:

"Finally, while I fully appreciate why patients in nations that have a history of M.E. would like to get rid of CFS entirely and not see it paired with M.E., please understand that doing so in the US means that CFS, the only name used in the vast majority of the medical establishment in the US (who never heard of M.E.), will be placed in R53 under "vague signs and symptoms" - not G93.3, in neurology, in ICD-10-CM."


This is a US centric issue and as a UK advocate, I don't involve myself in lobbying for a particular position. However, were I a resident of the US I would agree with Mary that placing CFS under the R53 codes, in Chapter 18 of ICD-10-CM may have significant implications for patients who currently have a Dx of CFS or who may be given a Dx of CFS in the future and that it will hurt them to have CFS coded under the R chapter. I also consider that it makes CFS and ME diagnosed patients more vulnerable to the current proposals for the revision of the "Somatoform Disorders" section of DSM-5.

Coding CFS in Chapter 18 under the R53 codes would also mean that ICD-10-CM is at odds with the following:

ICD-10

The Canadian Clinical Modification ICD-10-CA

The German Clinical Modification ICD-10-GM

The proposals for ICD-11 as they stood in the iCAT ICD Revision platform at November 2010



So these are my suggestions:

That you PM Cort and ask him what his position is on the proposed codings for ICD-10-CM and why he has not published anything on this important issue, himself.

That you contact your US advocates and ask how you might assist - because endless circular discussion on this forum is not going to result in any changes being made to the current proposals - if change is what you want.

That you contact your leading US patient organisations. Ask them for public position statements (which you publish in this thread) and for updates on what action, if any, they are currently engaged in over this issue.


Better still, why not ask Cort to get "Abraham" to channel a summary for you?


As I say, this will be my final post here.

For information on ICD-10, DSM-5, ICD-11 and the forthcoming US specific ICD-10-CM and updates on latest developments please refer, in future to my website at:

http://dxrevisionwatch.wordpress.com

or you can contact me through the Contact form on either of my sites.

Suzy Chapman
 
Messages
13,774
Hey Suzy... it' would be sad if you did stop posting here. You've been a great source of information for me. I'm not to sure why you're quitting, but wanted to send my best wishes for the future for you. Ta.
 

WillowJ

คภภเє ɠรค๓թєl
Messages
4,940
Location
WA, USA
It has been discussed at length in a previous thread on Phoenix Rising, though not recently, which is why I have commented on the apparent lack of current interest on Phoenix Rising.

This is the previous thread:

http://forums.aboutmecfs.org/showthread.php?4510-ME-and-cfs-to-be-classified-as-seperate-illnesses

ME and cfs to be classified as seperate illnesses


So, in order not to lose the considerable information and discussion that has already taken place on this forum, I suggest that the starter of this thread, Willow, gives consideration to asking the mods to combine the two threads. Otherwise folk are going to have to repeat information that has already been posted, rather than link to a previous post or posts where information or concerns or the history of this issue are already set out.

Does the thread originator have to be the one to do that? Sorry, I have been away from the forums.

Yes, can a mod please combine this with the other thread? This should wake up the other thread and put that info easy to get to (even for people like me that don't find forum searches easy to do).

Suzy, I'm also sad to see you go.