10.05.2015

Why the “new” ICD10 fibromyalgia code doesn’t matter

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Why the "new" ICD10 fibromyalgia code doesn't really matter | FedUpwithFatigue.com

I’ve debated whether or not to write this post because doing so makes me feel like a killjoy. Good news is rare in the fibromyalgia community, and last week many people were overjoyed when they heard that fibromyalgia was listed as a diagnosis in the newly adopted (at least in the U.S.) ICD10 medical coding system. This story from NationalPainReport.com made the rounds on the Internet, with many U.S. readers proclaiming “It’s about time!” and those in other countries left wondering, “When will fibromyalgia be recognized as a real disease in MY country?”

I’m trained as both an ICD9 and ICD10 medical coder. It is true that ICD10 includes a diagnosis code for fibromyalgia, but ICD9 (the medical coding system used in the U.S. prior to Oct. 1, 2015) also included a diagnosis code for fibromyalgia. It was lumped together with some other medical terms associated with all-over body pain, but it was there.

American doctors have been using an ICD9 fibromyalgia code for years. If you’ve been diagnosed with fibro in the U.S. during the past few years, your doctor used the ICD9 code. My doctor used it to diagnose me.

The only thing that changed on Oct. 1 when the U.S. finally implemented ICD10 is that fibromyalgia got its own stand-alone line item. Fibro is no longer grouped with those other terms.

And for people who live outside the U.S. who wish their country would also “finally recognize” fibromyalgia … There’s good news! Your country probably already has! The U.S. is just the latest country (one of the last, in fact) to implement the ICD10 medical coding system. ICD10 is used throughout the world, so your doctor may have been using the “new” ICD10 fibromyalgia code for years. For example, ICD10 has been used in Australia since 1998. In Canada, it was rolled out between 2001-04, and it’s been the coding system in the U.K. since 2012.

In simple terms, ICD9 and ICD10 are billing/tracking codes used by healthcare providers. In the U.S., they are used primarily to bill insurance companies for services.

These codes are also used to track statistics related to certain conditions, so in that way, the ICD10 fibromyalgia code may prove somewhat beneficial to our community.

But ICD codes don’t really give legitimacy to any condition. If your doctor doesn’t believe in fibromyalgia, he isn’t required to use that code. He can diagnose you with something else and use another code altogether.

What this means is that, in my opinion, the ICD10 fibromyalgia code won’t have much of an impact. There will still be doctors who don’t believe in fibro. It will still be hard to win disability cases. It will still be difficult to get diagnosed and treated.

On a day-to-day basis, the only time the ICD10 fibromyalgia code will really matter is when a medical coder is using it so that a physician can get paid for his/her services.

I know this isn’t what the fibro community wants to hear, but sometimes a code is just a code.

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Comments

  1. Courtney says:

    Hi. The new code DOES matter. Fibro is standing by itself now. You said so yourself. Before it was lumped I. With others. Now it is standing on its own with its own specific code. So. It DOES matter.

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