ICD-10 coding error in Hansard

ICD-10 coding error in Hansard

Post #67 Shortlink: http://wp.me/pKrrB-Zi

The information in this mailing relates only to ICD-10, the current version of the WHO’s International Classification of Diseases that is used in the UK and in over 100 countries worldwide.

It does not relate to the forthcoming US specific Clinical Modification of ICD-10, which is known as “ICD-10-CM”; nor does it relate to the Clinical Modifications: ICD-10-CA (Canada); ICD-10-GM (Germany); ICD-10-AM (Australia); ICD-10-TM (Thailand).

In February, the Countess of Mar tabled a House of Lords Written Question which contained an error relating to ICD-10 codings. This was published in Hansard when a Written Response was provided.

In March, I wrote to the Assistant Registrar, Office of the Parliamentary Commissioner for Standards, House of Commons, to enquire whether there was any mechanism through which factual errors published in Hansard might be addressed.

My enquiry was forwarded to Ms Judith Brooke, House of Lords Table Office, who responded on 5 April. Ms Brooke’s response was that the Table Office assists members in the drafting of questions and amendments can be made with the agreement of the member concerned. However, the factual accuracy of information presented in a question is the responsibility of the member. As the question has now been answered and published in Hansard there is no formal route for correcting it. Ms Brooke suggested that the matter might be drawn to the attention of the Countess of Mar.

It is understood that Dr Charles Shepherd (Trustee and Honorary Medical Adviser, The ME Association) has discussed, or intends to discuss this matter with Lady Mar.)

Since there is no mechanism for inserting amendments to factual errors in Hansard, I am setting out a clarification below:

The full Written Question and Written Response provided by Earl Howe (Parliamentary Under-Secretary of State, Department of Health) can be read here on Hansard.

The Written Question had included the statement:

“…in light of the fact that the WHO International Classification of Diseases 10 lists ME as a neurological disease with post viral fatigue syndrome (PVFS) under G93.3 and CFS as a mental health condition under F48.0 and that the latter specifically excludes PVFS, whether they will adhere to that classification.”

This statement is incorrect.

“Chronic fatigue syndrome” is not listed in ICD-10 as a mental health condition.

“F48.0” is the Chapter V: Mental and behavioural disorders coding for “Neurasthenia” and “Fatigue syndrome”

The “International Statistical Classification of Diseases and Related Health Problems 10th Revision Version for 2007” (The Tabular List) can be accessed online here:

http://apps.who.int/classifications/apps/icd/icd10online/

The codings and text for F48.0 are here:

http://apps.who.int/classifications/apps/icd/icd10online/?gf40.htm+f480

The Exclusions to F48.0 are:

asthenia NOS ( R53 )
burn-out ( Z73.0 )
malaise and fatigue ( R53 )
postviral fatigue syndrome ( G93.3 )
psychasthenia ( F48.8 )

In ICD-10, Chronic fatigue syndrome is not listed in the Tabular List under any chapter but appears in Volume 3: The Alphabetical Index, where it is indexed to code G93.3 – the same code at which “Postviral fatigue syndrome” and “Benign myalgic encephalomyelitis” are classified.

ICD-10 Volume 3: The Alphabetical Index is not published by the WHO online but an unauthorised electronic copy can be accessed here:

(Page 528, top right-hand column)

http://www.scribd.com/doc/7350978/ICD10-2006-Alphabetical-Index-Volume-3

Scanned images of the index entry for Chronic fatigue syndrome in Volume 3: The Alphabetical Index can be viewed here:

http://www.meactionuk.org.uk/G93-3-ICD-10-index.jpg   (whole page)
http://www.meactionuk.org.uk/G93-3-ICD-10-index-closeup.jpg   (close up)

Classifications and codings for PVFS, ME and CFS in ICD-10 are set out clearly on these pages of my site:

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

The Countess of Mar and Earl Freddie Howe are both Patrons to the Young ME Sufferers Trust.