World Health Organization
The International Classification of Diseases 10th Revision (ICD-10) is the global standard diagnostic classification of diseases for use in epidemiology, health management and clinical practice. ICD is maintained and published by the World Health Organization (WHO).
How disease terms are classified has implications for commissioning of services and may negatively influence the perceptions of researchers, clinicians, allied health professionals, medical insurers and agencies involved with benefits assessment, provision of social care, access to disability adaptations and workplace and education accommodations.
The next major revision of ICD (ICD-11) has been in development since 2007.
In June 2018, the WHO published a stable version of ICD-11 as an “advance preview” to enable Member States to start planning for implementation of the new edition.
On May 25, 2019, the World Health Assembly (WHA) voted unanimously to adopt ICD-11.
WHA’s endorsement of the new edition won’t come into effect until January 01, 2022, which is the earliest date from which Member States can begin using ICD-11 for reporting data.
There is no mandatory implementation date and Member States will migrate to ICD-11 at their own pace and according to their countries’ specific timelines, requirements and resources. During this transitional period, the WHO will accept data recorded using ICD-10 or the new ICD-11 code sets.
The progress of the G93.3 terms through the ICD-11 Alpha and Beta drafting stages has been a frustrating and tortuous journey hampered by a lack of transparency and accountability on the part of ICD Revision and an apparent indifference to maintaining effective stakeholder engagement.
How have the ICD-10 G93.3 terms been classified for ICD-11?
Download report at:
Dx Revision Watch
World Health Organization Executive Board members
MEMBERS OF THE EXECUTIVE BOARD AND TERM OF OFFICE
The Executive Board is composed of 34 persons who are technically qualified in the field of health, each designated by a Member State that has been elected to serve by the World Health Assembly. Member States are elected for three-year terms.
The affiliations appear in the style and the language used by the corresponding member of the Board.
Answer given by Mr Andriukaitis on behalf of the European Commission
Question reference: E-004360/2018 (2018)
The World Health Organisation (WHO) International Classification of Diseases (ICD-10)(1) already includes Benign myalgic encephalomyelitis in code G93.3 for Postviral fatigue syndrome.
The draft ICD-11 maintains this disease in code 8E49 Postviral fatigue syndrome. The Commission works with the Member States on the development of the ICD. However, as an observer at the WHO, the Commission does not intend to make formal representations regarding official recognition of any disease.
The EU Framework Programme for Research and Innovation — Horizon 2020 (2014-2020)(2) — provides many opportunities for supporting research on myalgic encephalomyelitis. These efforts aim to advance basic understanding of the disease, provide better diagnostic tools, and develop new and improved therapeutic interventions. Information on the current funding opportunities is available via the Participant Portal(3).
The Commission also supports the COST programme for European Cooperation in Science and Technology. COST recently created an integrated network of researchers working on myalgic encephalomyelitis — EUROMENE(4).
As regards education and training of health and social care professionals, in accordance with Articles 165 and 166 of the Treaty on the Functioning of the EU(5) Member States are responsible for the content and the organisation of their education systems and vocational training. At the same time, in accordance with Article 168 of the Treaty, Member States are also responsible for the organisation and delivery of health services and medical care.
18 June 2018 ¦ Geneva: The World Health Organization (WHO) is today releasing its new International Classification of Diseases (ICD-11).
The ICD is the foundation for identifying health trends and statistics worldwide, and contains around 55 000 unique codes for injuries, diseases and causes of death. It provides a common language that allows health professionals to share health information across the globe.
“The ICD is a product that WHO is truly proud of," says Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “It enables us to understand so much about what makes people get sick and die, and to take action to prevent suffering and save lives."
ICD-11, which has been over a decade in the making, provides significant improvements on previous versions. For the first time, it is completely electronic and has a much more user-friendly format. And there has been unprecedented involvement of health care workers who have joined collaborative meetings and submitted proposals. The ICD team in WHO headquarters has received over 10 000 proposals for revisions.
ICD-11 will be presented at the World Health Assembly in May 2019 for adoption by Member States, and will come into effect on 1 January 2022. This release is an advance preview that will allow countries to plan how to use the new version, prepare translations, and train health professionals all over the country.
The ICD is also used by health insurers whose reimbursements depend on ICD coding; national health programme managers; data collection specialists; and others who track progress in global health and determine the allocation of health resources.
The new ICD-11 also reflects progress in medicine and advances in scientific understanding. For example, the codes relating to antimicrobial resistance are more closely in line with the Global
Antimicrobial Resistance Surveillance System (GLASS). ICD-11 is also able to better capture data regarding safety in healthcare, which means that unnecessary events that may harm health – such as unsafe workflows in hospitals - can be identified and reduced.
The new ICD also includes new chapters, one on traditional medicine: although millions of people use traditional medicine worldwide, it has never been classified in this system. Another new chapter on sexual health brings together conditions that were previously categorized in other ways (e.g. gender incongruence was listed under mental health conditions) or described differently. Gaming disorder has been added to the section on addictive disorders.
They appear to have officially added both ME & CFS under the Post Viral tab but not as one entity and CFS only if it is caused by a virus. But It’s still under discussion. WHO tells us they are reviewing research. These are the research areas they are reviewing.
Search results 1 - 4 of 4 results for Myalgic Encephalomyelitis and Chronic Fatigue Disease
WHO | Global Advisory Committee on Vaccine Safety, 12-13 ...
... and severity of AEFI reported with the use of live Japanese
encephalitis vaccine (JEV ... Despite media reports on possible increased
risk of myalgic encephalomyelitis (ME), also called ...
Doc covers 2pdf
Page 1. WHO, Geneva, Switzerland World Health Organization
Communicable Diseases Cluster CDS Staff by Area of
Responsibility at 1 September / au 1er septembre 2002 ...
... Includes: specified viral: • encephalomyelitis NEC • meningoenc
ephalitis NEC Excludes: benign myalgic encephalomyelitis
(G93.3) encephalitis due to: • herpesvirus [herpes simplex ...
The ICD-10 Classification of Mental and Behavioural ...pdf
... global dementia, mutism, and death. Includes: AIDS-dementia complex HIV
encephalopathy or subacute encephalitis F02.8 Dementia in other specified http://www.who.int/classifications/icd/en/bluebook.pdf
Body Distress Disorder https://icd.who.int/browse11/l-m/en#/http://id.who.int/icd/entity/767044268
World Health Assembly
The World Health Assembly is the decision-making body of WHO. It is attended by delegations from all WHO Member States and focuses on a specific health agenda prepared by the Executive Board. The main functions of the World Health Assembly are to determine the policies of the Organization, appoint the Director-General, supervise financial policies, and review and approve the proposed programme budget. The Health Assembly is held annually in Geneva, Switzerland.
The World Health Assembly is the decision-making body of WHO. It is attended by delegations from all WHO Member States and focuses on a specific health agenda prepared by the Executive Board. The main functions of the World Health Assembly are to determine the policies of the Organization, appoint the Director-General, supervise financial policies, and review and approve the proposed programme budget. The Health Assembly is held annually in Geneva, Switzerland
Update May 2018 WHO ICD 11
Public domain document PDF
Comparison of Classification and Terminology Systems,
Mary Dimmock & Chapman, May 2018
PDF can be downloaded from this URL:
The ICD-11 Beta draft was frozen on April 4, 2018 for quality assurance purposes.*
Dr John Grove (WHO Director, Information, Evidence and Research, ICD Revision Project Lead) has said that the draft is planned to be frozen again at the end of May. Here's a screenshot from the April Frozen Release for the listing for PVFS, BME and CFS.
Update on current status of proposals for ICD-11 for the ICD-10 G93.3 terms:
Postviral fatigue syndrome
Benign myalgic encephalomyelitis
Chronic fatigue syndrome
Progression of PVFS, ME and CFS through the ICD-11 drafting platforms
Key events in the timeline: tracking the progress of the ICD-10 G93.3 legacy terms through the initial iCAT, Alpha and Beta drafting platforms, from May 2010 to May 2018.
Also available as a PDF:
Whatever is in the Beta draft at the point at which the draft is frozen at the end of May should go forward to the initial release in June, though not all chapters may include “Description” texts.
After release, ICD Revision might potentially post newproposals for PVFS, ME and CFS via the Proposal Mechanism, which will remain open for submission of new proposals.
PVFS in the ICD-11 Foundation view
PVFS in the ICD-11 Mortality and Morbidity Statistics Linearization
To view or comment on Proposals or to add comments to the Beta listings you will first need to register here
WHO ICD 10
Myalgic Encephalomyelitis is a debilitating neurological disease which has been recognized by the World Health Organisation (WHO) since 1969 as a distinct organic neurological disorder. M.E. is classified in the current WHO International Classification of Diseases with the neurological code G.93.3.
The World Health Organization (WHO) classifies all known diseases in its International Classification of Diseases (ICD). The WHO states: 'The ICD is the international standard diagnostic classification for all general epidemiological, many health management purposes and clinical use.'
Myalgic Encephalomyelitis (M.E.) has been recognized and classified by the ICD since 1969 following the seminal work of Dr. Melvin Ramsay and others.
The WHO recognizes M.E.
ICD-10 classifies M.E. under Diseases of the nervous system. In other words, the WHO states that M.E. is a neurological disease.
In the version of the ICD currently in use in most of the world except the US (ICD-10) M.E. is classified as a neurological disease. (ICD-10 is currently used in the UK, Australia, Europe, Canada and other countries. ICD-10 is the responsibility of the WHO, Geneva. ICD-10 CM (USA) will be used in future in the US. Planned implementation is in 2013.)
In a world where the reality of M.E. is denigrated and denied by doctors, policy-makers and the general public, the ICD-10 classification of M.E. as a neurological disease is an important instance of the disease being given appropriate official recognition by the medical and scientific establishment.
M.E. is classified in the current WHO International Classification of Diseases with the neurological code G.93.3.
"The term Myalgic Encephalomyelitis has been included by the World Health Organisation (WHO) in their International Classification of Diseases (ICD), since 1969. The current version ICD-10 lists M.E. under G.93.3 - neurological conditions. It cannot be emphasised too strongly that this recognition emerged from meticulous clinical observation and examination."
Professor Malcolm Hooper
ICD-10 and 'CFS'
'CFS' is not classified in the Tabular list (the main body of the code listings) of ICD-10. 'CFS' is present in the Alphabetical index, published only in CD-ROM and book form, not online. 'CFS' has been listed in the index of ICD-10 since it was published in 1994.
'CFS' in the index is indexed to G93.3. What does this mean? Clearly it indicates that 'CFS' has some relationship to the diseases at G93.3, i.e. PVFS and Benign ME, but what is this relationship?
ICD-10 does not say that 'CFS' is synonymous with M.E. ICD-10 is silent as to the relationship between CFS, and PVFS and ME.
ICD-10 gives various possible relationships between a term in the Alphabetical index, and the term in the Tabular list to which it is indexed. It may be:
'a diagnostic term currently in use'
an 'imprecise and undesirable term' or 'a rubric for ill-defined conditions' (all from Introduction to ICD-10 Vol.3, 2nd Edn.)
'a best coding guess' (correspondence from the WHO).
However, ICD-10 does not specify which of these possible relationships applies in the case of 'CFS.' Thus ICD-10 does not specify what relationship 'CFS' has with M.E.
Nor has the WHO issued any statement which specifies the relationship between 'CFS' and M.E., despite requests for clarification.
ICD-10 and Combined Terms 'ME/CFS' and 'CFS/ME'
No version of the WHO ICD classifies the terms 'ME/CFS' or 'CFS/ME.' Nor do any past or currently planned future versions of the ICD classify either of these terms. Not only does the ICD not classify these terms, it does not mention them at all.
Thus according to the ICD, 'ME/CFS' and 'CFS/ME' do not exist. The combined terms equate M.E. with 'CFS.' This harms M.E. patients.
M.E. and 'CFS' are not the same, so the combined terms are meaningless; they only increase confusion, which helps those who try to deny the medical reality of our disease, and give the impression that M.E. is 'mysterious.'
The main problem with the term 'CFS' is that 'CFS' does not exist. The definitions of 'CFS describe a heterogeneous group of patients suffering from a vast array of different diseases which cause fatigue. The mixed-bag definitions of 'CFS' lend themselves to psychiatric interpretation, and yield meaningless research results.
The term 'ME/CFS' does the same harm to the cause of M.E. as the term 'CFS/ME,' by equating M.E. with 'CFS.' Equating the two, so M.E. patients are subsumed into the ill-defined morass of 'CFS,' is one of the most important strategies of those who deny the biomedical reality of M.E.
Neither combined term is justified by ICD-10. The combined terms imply that 'CFS' and 'M.E.' are alternative names for the same disease, but ICD-10 does not say that 'CFS' is the same as M.E.
'CFS' is in the index, indexed to the same code as PVFS and ME, but this does not mean it is synonymous with those diseases. As discussed above, there are several possible relationships between a term in the index and the term at the code to which it's indexed. Thus ICD-10 does not justify using the two terms as though they are synonyms.
The ICD does not recognize either 'ME/CFS' or 'CFS/ME.' The absence of the combined terms from the ICD may be useful in our efforts to resist them.
US ICD versions, M.E., 'CFS' and Combined Terms
M.E. is hardly recognised in the US. The disease formerly described as 'epidemic neuromyasthenia' in the US is now more likely to be diagnosed as 'CFS.' Unfortunately there is currently no classification for M.E. in the Tabular list of ICD-9 used in the US. The closest to a classification of M.E. in ICD-9 is Unspecified cause of encephalitis, myelitis, and encephalomyelitis, which is in practice seldom used. The lack of a listing for M.E. will be rectified in ICD-10 CM (USA) to be used in the US from 2013, which has a classification for M.E. as a neurological disease.
Unlike ICD-10, the US versions of the ICD are quite clear about the relationship between 'CFS' and M.E.: there is none. Amy Blum, Medical Classification Specialist at the National Center for Health Statistics has stated:
'ME is not considered a synonymous term for chronic fatigue syndrome in the United States.'
Ms. Blum has also made the following illuminating statement:
'...it is not clinically valid to classify all cases of CFS to code G93.3. The default will be R53.82 except in those cases where the cause is determined to be of viral origin.'
(email to me, 9 July 2009)
'CFS' is coded in a completely different category from M.E. in the US. ICD-9, currently used, does not classify M.E. as such, and the nearest equivalent is at 323.9 under Diseases of the nervous system and sense organs while 'CFS' is at 780.71 under Symptoms, signs, and ill-defined conditions.
ICD-10 CM (USA), for use in future, classifies M.E. at G93.3 under Diseases of the nervous system, while 'CFS' is at R53.82 under Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified.
Combined terms 'ME/CFS' and 'CFS/ME'
The combined terms are not supported by ICD-10; still less are they supported by the US ICD versions. As discussed above, M.E. and 'CFS' are at completely different codes within different categories. Thus the combined terms, which equate 'CFS' with M.E., are not supported by the US ICD versions.