ICD-10 Coding for Fatigue and Malaise(R53.0, R53.82, R53.83)
Complete ICD-10-CM coding and documentation guide for Fatigue and Malaise. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Fatigue and Malaise
R53Primary Range
Malaise and fatigue
This range includes codes for various types of fatigue and malaise, including chronic fatigue syndrome and neoplastic fatigue.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| R53.0 | Neoplastic (malignant) related fatigue | Use when fatigue is directly linked to an active malignancy or its treatment. |
|
| R53.82 | Chronic fatigue, unspecified | Use for chronic fatigue lasting more than 6 months with no identifiable cause. |
|
| R53.83 | Other fatigue | Use for non-chronic fatigue without a specific cause. |
|
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
Essential facts and insights about Fatigue and Malaise
Primary ICD-10-CM Codes for fatigue and malaise
Decision Criteria
clinical Criteria
- Fatigue directly related to cancer treatment
Applicable To
- Fatigue due to cancer
- Fatigue due to chemotherapy
Excludes
- Fatigue not related to neoplasm
Clinical Validation Requirements
- Documentation of active malignancy
- Linkage to cancer treatment
Code-Specific Risks
- Incorrect sequencing with malignancy code
Coding Notes
- Ensure malignancy is coded first to avoid sequencing errors.
R53.82 - Chronic fatigue, unspecified
Use for chronic fatigue lasting more than 6 months with no identifiable cause.
Applicable To
- Chronic fatigue syndrome NOS
Excludes
- Chronic fatigue syndrome with PEM (G93.3)
Clinical Validation Requirements
- Fatigue lasting ≥6 months
- Exclusion of other causes (e.g., anemia, thyroid disorders)
Coding Notes
Ensure thorough documentation of exclusionary tests.
R53.83 - Other fatigue
Use for non-chronic fatigue without a specific cause.
Applicable To
- Fatigue NOS
- Lethargy
Excludes
- Chronic fatigue syndrome (R53.82)
Clinical Validation Requirements
- Fatigue impacting daily activities
- No chronicity or specific cause
Coding Notes
Document the impact on daily activities to justify use.
Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Fatigue and Malaise to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code R53.0.
Impact
Clinical: Inadequate clinical picture, Regulatory: Potential audit failure, Financial: Denied claims
Mitigation Strategy
Specify duration and impact, Use precise terminology
Impact
Reimbursement: Incorrect DRG assignment, Compliance: Non-compliance with ICD-10 guidelines, Data Quality: Inaccurate clinical data representation
Mitigation Strategy
Use G93.3 for ME/CFS with PEM.
Impact
Failure to sequence malignancy before R53.0.
Mitigation Strategy
Educate staff on proper sequencing rules.
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 and Malaise, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Fatigue and Malaise
Use these documentation templates to ensure complete and accurate documentation for Fatigue and Malaise. These templates include all required elements for proper coding and billing.
Chronic fatigue in primary care
Specialty: Primary CareRequired Elements
- Duration of fatigue
- Exclusionary test results
- Impact on daily activities
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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