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G93.32

Billable

Myalgic encephalomyelitis/chronic fatigue syndrome

This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).

What This Code Means

Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a long-term condition characterized by extreme tiredness that doesn't improve with rest, along with muscle pain and cognitive difficulties. Symptoms worsen with physical or mental exertion and can significantly impact daily functioning.

Coding Tips

  • This code should only be used when ME/CFS is formally diagnosed; fatigue alone without confirmed ME/CFS diagnosis should be coded differently (such as R53.82 for chronic fatigue)
  • Document the specific symptoms present (post-exertional malaise, cognitive impairment, sleep disturbance) in the medical record to support the diagnosis and justify medical necessity for treatment

Code Hierarchy

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