ICD-10 Coding for Fatigue Syndrome(G93.32, R53.82)
Complete ICD-10-CM coding and documentation guide for Fatigue Syndrome. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Fatigue Syndrome
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| G93.32 | Chronic fatigue syndrome (CFS) | Use when the patient meets the CDC criteria for ME/CFS. |
|
| R53.82 | Chronic fatigue, unspecified | Use when fatigue is chronic but does not meet ME/CFS criteria. |
|
Clinical Decision Support
Always review the patient's clinical documentation thoroughly. When in doubt, choose the more specific code and ensure documentation supports it.
Key Information: ICD-10 code for chronic fatigue syndrome
Essential facts and insights about Fatigue Syndrome
Primary ICD-10-CM Codes for fatigue syndrome
Decision Criteria
clinical Criteria
- Patient exhibits symptoms consistent with ME/CFS for more than 6 months.
documentation Criteria
- Detailed symptom documentation and exclusion of other conditions.
Applicable To
- Myalgic encephalomyelitis
Excludes
- Fatigue NOS (R53.83)
Clinical Validation Requirements
- ≥6 months of fatigue
- Post-exertional malaise
- Unrefreshing sleep
- Cognitive impairment
Code-Specific Risks
- Requires detailed documentation of symptoms and exclusion of other conditions.
Coding Notes
- Ensure all ME/CFS criteria are documented to support this code.
R53.82 - Chronic fatigue, unspecified
Use when fatigue is chronic but does not meet ME/CFS criteria.
Excludes
- Chronic fatigue syndrome (G93.32)
Clinical Validation Requirements
- Fatigue lasting more than 6 weeks
- Exclusion of ME/CFS criteria
Coding Notes
Ensure documentation clearly states why ME/CFS criteria are not met.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Neoplastic (malignant) related fatigue
R53.0Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Fatigue Syndrome to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code G93.32.
Impact
Clinical: May lead to misdiagnosis., Regulatory: Non-compliance with coding standards., Financial: Potential for claim denials.
Mitigation Strategy
Ensure comprehensive symptom documentation, Use structured templates
Impact
Reimbursement: May result in lower reimbursement rates., Compliance: Risk of non-compliance with coding guidelines., Data Quality: Impacts accuracy of patient records.
Mitigation Strategy
Differentiate between general chronic fatigue and ME/CFS.
Impact
Inaccurate or incomplete documentation can lead to audit issues.
Mitigation Strategy
Use detailed templates and ensure all criteria are met.
Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.
Frequently Asked Questions
Common questions about ICD-10 coding for Fatigue Syndrome, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Fatigue Syndrome
Use these documentation templates to ensure complete and accurate documentation for Fatigue Syndrome. These templates include all required elements for proper coding and billing.
Chronic Fatigue Syndrome Diagnosis
Specialty: Internal MedicineRequired Elements
- Patient history
- Symptom duration
- Exclusion of other conditions
- Functional impact
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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