The day that many fibromyalgia sufferers have been waiting for has finally come. Fibromyalgia is real and is now recognized as such by the Centers for Medicare and Medicaid Services and the National Center for Health Statistics.
Effective October 1, 2015, fibromyalgia has its own diagnosis code that is included in the list of official diagnostic codes used by the U.S. healthcare industry including doctors, insurance companies and government agencies. ICD-10-CM (International Classification of Diseases, 10th Revision, Clinical Modification) is the most recent revision to the list of these codes that now includes fibromyalgia. Previously, doctors had to use a general code called “myalgia and myositis, unspecified.”
This new official recognition of fibromyalgia is worthy of celebration for sufferers, many of whom have long faced disbelief and skepticism about the legitimacy of fibromyalgia as a real disease from family, friends and even medical professionals. This is now the third U.S. government agency to officially recognize fibromyalgia. In 2007, the FDA approved Lyrica for the treatment of fibromyalgia. And in 2012, the Social Security Administration issued a ruling providing guidance to its disability examiners and judges on how to evaluate fibromyalgia for purposes of disability claims.
Other expected benefits of fibromyalgia’s inclusion in the new ICD codes:
Insurance companies will no longer be able to deny reimbursement for medical costs related to fibromyalgia by insisting that it isn’t a real condition. Having its own diagnostic code closes that loophole.
The chances of being approved for Social Security Disability benefits may increase for those citing fibromyalgia as the disabling condition since the previous lack of a specific diagnostic code can no longer be used as a reason for denial of benefits. U.S. residents not already receiving disability benefits who have worked at least 5 of the last 10 years canclick here for a free disability benefits evaluation from our recommended network of disability advocates.
Improvements in the quality of fibromyalgia research studies due to the more specific selection of fibro-specific test subjects.
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