Post Viral Fatigue Syndrome: Chiropractic CPT Code Changes

Highlights 

• The CPT code G93.31 refers to post viral fatigue syndrome. 

• The new code emerged in 2023 as part of a reorganization of post-viral fatigue and related syndromes under the parent code, CPT code G93.3.

• The update allows chiropractors to code and bill for post-viral syndrome, differentiating it from chronic fatigue.

A new ICD-10-CM code, CPT code G93.31, denotes post viral fatigue syndrome, which includes physical and cognitive symptoms that become more severe over time. The new CPT code helps your practice distinguish from related fatigue syndromes and better treat your patient’s condition. Discover how the code affects your billing and reimbursement workflows to ensure you receive timely payment.

CPT Code G93.31: What is Post Viral Fatigue Syndrome?

When patients recover from a viral infection, they may experience lingering fatigue and weakness, referred to as post-viral fatigue syndrome. They may feel unwell and drained of energy for days or months as an inflammatory reaction to a virus.

Any viral infection causes this syndrome, including the common cold, pneumonia, and HIV. Post fatigue syndrome is common among COVID-19 patients with mild and asymptomatic symptoms. A 2020 study of 3,762 COVID-19 patients in 56 countries reported constant fatigue, cognitive impairment, and post-exercise malaise for approximately seven months after their infections.

Post viral syndrome might cause additional symptoms, including:

• Confusion
• Concentration issues
• Headaches
• Muscle pain and aches
• Sore throat
• Stiff joints
• Swollen lymph nodes

Post-viral syndrome may present symptoms similar to chronic fatigue syndrome (CFS) or myalgic encephalomyelitis, so doctors might treat it similarly. The new code is relevant to chiropractors because they often treat chronic fatigue symptoms in their patients.

For example, you may help patients with CFS by suggesting lifestyle changes, dietary modifications, and gentle exercise regimens. Providers must understand the difference between the CPT codes to ensure correct coding when submitting insurance claims.

What is the Difference Between Post Viral Fatigue Syndrome and Chronic Fatigue?

Since no standardized tests distinguish CFS or post viral fatigue syndrome, a provider provides a diagnosis by ruling out other diseases and reviewing a patient’s medical history. For instance, a diagnosis of post-viral fatigue syndrome requires a 50% or more reduction in physical function and profound fatigue for at least six months after an illness.

However, a patient must experience fatigue without explanation for at least six months to receive a diagnosis of chronic fatigue syndrome. The origins of CFS remain unclear. The World Health Organization states that medical professionals do not have a centralized agreement regarding how to diagnose chronic fatigue syndrome correctly.

Since CFS and post-viral fatigue syndrome did not have distinct codes, providers used the ICD-10-CM code R53.82 for chronic fatigue syndrome. The ICD-10 Coordination and Maintenance Committee reported that the code made it difficult to track and diagnose the syndrome separately from chronic fatigue symptoms.

Some providers refused to diagnose myalgic encephalomyelitis when there is no viral origin because the previous G93.3 title stated post-viral illness at the time.

To remedy the confusion among medical providers, the updated chiropractic CPT codes for 2023 include the new CPT code to distinguish post-viral fatigue syndrome from CFS, myalgic encephalomyelitis, and other conditions.

Changes to CPT Code G93.3

The CPT code for G93.3 expanded its title to include related fatigue syndromes. Under G93.3, post-viral fatigue syndrome has the CPT code G93.31. Providers and billers may enter this code for fatigue symptoms stemming from post-viral illnesses.

The code remains separate from the CPT code G93.32 for chronic fatigue syndrome. It applies to myalgic encephalomyelitis/chronic fatigue syndrome, chronic fatigue syndrome, and myalgic encephalomyelitis.

The update to G93.3 also directs providers and coders to use the code U09.9 for a post-COVID-19 condition if necessary. This optional code ensures they give an accurate diagnosis after a COVID-19 infection.

The new code enables chiropractors to document it in their medical records, making billing and receiving reimbursement for care related to post-viral fatigue syndrome easier. It also allows providers to accurately track the syndrome among their patients, so they can receive the care they need to regain their energy and manage their symptoms.

How to Simplify Chiropractic Billing with ChiroTouch

Precise CPT coding and documentation for your patients is crucial for successful insurance reimbursement. Chirotouch’s integrated chiropractic billing and coding features ensure your practice meets its revenue goals and submits accurate claims to payers.

Integrated Coding Functions

ChiroTouch syncs the codes from your provider SOAP notes to the billing screen, reducing errors and time spent manually entering codes. The ICD mode in the patient management screen is editable; it allows you to change the ICD-10 code for a specific insurance policy, so your practice stays updated for all the latest code changes.

For every patient appointment, providers can set up default diagnoses and charges. These settings don’t simply copy the charges and diagnoses from the previous appointment; they set up the diagnoses and charges for the patient.

The default mode minimizes the likelihood of possible coding errors and HIPAA violations, which cost you money and damage your practice’s reputation.

Save Time and Reduce Errors with Macros

Chirotouch has pre-formatted EasyTouch macros for high-volume practices that only take payments. If your practice has multiple providers and accepts insurance, you can take your revenue to the next level with BulletTouch macros to help you reduce errors and boost efficiency.

These macros help you choose the patient care and treatment, record patient concerns, and document the procedure you carried out with the push of a button. You can set up your macros to meet the requirements of third-party payers and ensure your SOAP notes are accurate.

The touchscreen dashboard lets you choose the type of patient care and record their intake responses. You can also select the chiropractic billing codes for the treatments you provide to your patients. This data seamlessly integrates with your chiropractic billing software and enables you to submit accurate claims to insurance companies.

Explore ChiroTouch for Chiropractic Billing

ChiroTouch’s chiropractic practice management software frees your practice from manual data entry with streamlined billing and accurate codes. When you use the software’s integrated coding functions and macros in your SOAP notes, you keep your practice compliant, boost productivity, and concentrate on helping your patients heal from post-viral fatigue syndrome.

Book a demo today to learn how Chirotouch streamlines your coding and billing workflows to help you meet your revenue goals.