Stick with a single code once your physician reaches a diagnosis.
Chronic fatigue syndrome (CFS) is a mysterious condition for physicians, patients, and family members alike. The symptoms of CFS can mimic other health problems, making the condition difficult to officially diagnose. Physicians must rule out other illnesses such as sleep disorders, mental health issues, or other medical problems with associated fatigue (such as anemia or hypothyroidism) before diagnosing CFS.
Once you have confirmation of a diagnosis, the correct ICD-9 code is 780.71 (Chronic fatigue syndrome). ICD-9 lists several similar conditions that are excluded from 780.71, such as unspecified debility (799.3) and fatigue due to heat (992.6), pregnancy (646.8), or neurasthenia (300.5).
ICD-10 choice: You’ll continue to have a single diagnosis code for CFS in ICD-10: R53.82 (Chronic fatigue, unspecified). This will include chronic fatigue syndrome NOS, but will exclude post-viral fatigue syndrome (which you’ll report with G93.3).
Category explanation: Diagnosis R53.82 will be part of the R chapter of codes that represent “Symptoms, signs, and abnormal clinical and laboratory findings, not elsewhere classified.” The more specific category will be R50-R69 (General symptoms and signs). R codes will represent symptoms, signs, abnormal results of clinical or other investigative procedures, and ill-defined conditions that cannot be classified by a more definitive diagnosis.
According to ICD-10 guidelines, the conditions and signs or symptoms included in categories R00-R94 consist of:
Coding tips: Remember that signs and symptoms that are routinely associated with a disease process should not be assigned as an additional diagnosis code unless coding guidelines instruct you otherwise. You might report signs and symptoms as the diagnosis when the physician initially sees the patient because he has not reached a firm diagnosis. Once he diagnoses the condition, however, you should report that code instead of the signs/symptoms codes.