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Yes, it is true that G93.3 is no longer billable because it is now a parent code for which additional subcodes have been added. That means providers have to use one of the subcodes instead. But NCHS has stated that instructions placed at the parent level G93.3 apply to ALL subcodes under G93.3...

Its possible for a person to have PEM but not meet the full criteria for ME. Right now, we are not tracking that

For those in the US, its also available on Amazon - link I'm still reading but so far, it's exceeding my expectations in terms of its breadth and its targeted advice for PTs Edited to fix the link

Clinicians know that they are to code the disease, not the symptom, when that symptom is a core part of the disease. So the only way I could see a doctor diagnosing PEM and not ME/CFS in when ME/CFS exists is if the doctor knows about and is able to identify PEM - and yet does not know about...

From the article... "When considering implementation of an exercise protocol, it is critical to emphasize the importance of a graded increase in exercise duration and intensity, so as to avoid post-exertional malaise that may otherwise limit adherence to the program.54 At the same time, it is...

My son was first diagnosed with giardia and then an acute but previously undetected case of Lyme using CDC's recommended test. (We are 10 miles from Lyme and ticks are everywhere). Shortly after that testing, he woke up one day to the full reality of ME. His most significant period of...

While they exclude those with PESE at baseline, they don't mention monitoring for PESE during the study (after each 2 hour exercise session) and don't list using an outcome measure to check for PESE during the study. So they don't know if PESE resulted from their program

Perhaps I am missing something - does this say it's a pragmatic rehabilitation program? Edited to add: Are you referring to the sentence in the paper about comparing findings to Post-COVID Rehabilitation and Recovery Clinic at the University of Washington. My understanding is that the overall...

ECHO is a fairly wide-spread US education approach using remote technology and case-based learning to improve clinician practice and patient outcomes. It's often used to reach doctors in rural areas or to disseminate specialist knowledge, such as with Hep C. If I remember correctly, ECHO...

Or maybe enough to just be similar on intended outcomes - "improving coping strategies and improving overall well-being."

It apparently doesn't take much to decide they are similar. In the 2014 systematic treatment evidence review conducted in the US, the authors pooled all Counseling and Behavior Therapies (including CBT), together and then concluded that, collectively, these therapies improved fatigue, function...

Agree with this.

I agree its not sufficient to just monitor the post-trigger response for 90 minutes. But would that imply there are two separate biological processes going on, one for the immediate response and one for the next day response? Or could the evidence suggest there's one process/cascade of...

Good points. AFAIK, the studies of PEM have not looked at the cumulative effect of multiple triggers. Leaves me wondering how such a study would be conducted/what would be required.

In their research, Workwell has documented that some symptoms of PEM show up fairly soon after the onset of exercise (link) and have suggested that if patients are able to recognize these early symptoms, they can reduce the severity and/or duration of PEM by stopping/reducing the trigger...

@Dolphin - I compared the two lists and assuming I didn't make a mistake, all the originally listed authors above are in the published paper. But weirdly, Trudi Chalder wasn't in the above list but is on the published paper. I didn't check to see if they were still at the same institutions

This! There are over 70 peer-reviewed publications documenting objective evidence of an abnormal response to exercise challenges in ME/CFS - immune, neurological and cognitive, autonomic, metabolic and energy metabolism, gene expression, oxidative stress, etc. That evidence directly undermines...

Thank you for that context, @Arvo

Thanks for the information and for the documents, @MatthiasRiem and @Arvo. Very helpful and answers my question I agree it strains logic to use Fukuda but I see some here also who still use it. But I found this statement on page 8 of the research program document - might be enough to give...

(bold added) @Solstice - Do you know if the requirement to use the CCC, ICC, or IOM is listed anywhere on the ZonMW research program site or in their call for proposals? I looked on the site but didn't see it. That's a helpful statement for efforts elsewhere to get rid of Fukuda. Thanks in...