Multiple Chemical Sensitivity

  DIAGNOSTIC CODES for MCS and MUSES Syndrome

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Other Disorders, Signs and Symptoms Associated with Multiple Chemical Sensitivity

Compiled by Albert Donnay, MCS Referral & Resources, 410-889-6666, 2/1999, rev'd 8/2000

MCS is a highly variable organic disorder associated with many abnormal signs and tests (see Biomarkers of MCS). Since no single ICD-9 code yet exists for MCS all of the disorder's component manifestations should be comprehensively assessed and diagnosed. The disorders and conditions listed below (with ICD-9CM codes in parentheses) have signs and symptoms that overlap with MCS in some cases, and so they should be considered in any differential diagnosis. If a single distinct disorder aggravated by chemical exposures such as asthma, mastocytosis, migraine or porphyria can account for all the patient's signs, symptoms and history of chemical sensitivity, no alternative explanation may be needed, and the diagnosis of MCS may be excluded.

Chronic fatigue syndrome, fibromyalgia and the CDC's recently proposed "chronic multi-symptom illness" are not defined as chemical sensitivity disorders and should be diagnosed separately, even though they share most of the same abnormal signs, tests and symptoms.

If no single diagnosis can account for all the signs, symptoms and history associated with chemical exposure --as is more commonly the case-- then any significant disorders whose diagnostic criteria are met should be diagnosed, including MCS if multiple symptoms are provoked in multiple organs by exposure to --and ameliorated by avoidance of-- multiple chemicals at levels below those previously or commonly tolerated.

If MCS is due to a poisoning, the agent involved should be specified (9**), and the type of exposure specified (E9**).

Only a few of these codes -- for carbon monoxide and pesticide poisoning -- are included below.

Follow these Wikipedia links to look up other ICD-9 codes and new ICD-10 codes.

Specific Diseases

Adrenal Disorder (255.*)

Allergy (473.*)

Anemia, Hemolytic (282.*, 283.*)

Arthritis or Arthralgia (various)

Asthma (493.**, 506.30 if from fumes)

Attention Deficit Disorder (314.0)

Autism, Infantile (299.0)

Brain Hypoxic injury (348.1)

Brucellosis (023.*)

Candida (112.*)

Carbon Monoxide (see Poisoning below)

Chronic Fatigue Syndrome (780.71)

Depression: Chronic, Manic, SAD (various)

Dermatitis, atopic (691.8)

Diabetes (250.**)

Encephalopathy, Toxic (349.82)

Epilepsy (various seizure disorders)

Fibromyalgia (729.1)

Food Intolerance (579.8)

Gastroenteritis & colitis, toxic (558.2)

Hay Fever (477.*)

Heart Disease (various)

Hemochromatosis (275.0 or 285.0 with refractory anemia)

Hypotension (various)f

Hypothyroidism (244.*)

IgA Deficiency (279.*)

Inflammatory Bowel Disease (558.9)

Irritable Bowel Syndrome (564.*)

Lyme Disease (088.81)

Malabsorption (579.*)

Mast Cell Disease (202.6, 757.33)

Migraine (346.**)

Mitral Valve Prolapse (424.0)

Multiple Sclerosis (340.**)

Myasthenia Gravis (358.0)

Myofacial Pain Syndrome (729.1)

Neuromyasthenia (049.8)

Neurasthenia (300.5); cardiac N. (306.2);
Gastric N. (306.4); post viral N. (780.7)

Otitis, chronic or recurrent (various)

Neuropathy (various: peripherial, poly)

Poisoning (9**.**) from external cause such as:

Pellagra (265.2)

Polyps, Nasal (471.*)

Porphyrin disorder (277.1)

Raynaud's Syndrome (443.0)

Reactive Airways Dysfunction Syndrome (RADS)
Reactive Upper Airway Dysfunction Syn. (RUDS)

Rhinitis, chronic (472.0) or allergic (477.9)

Scleroderma (710.1)

Sinusitis (various)

Sjogren's Syndrome (710.2)

Systemic Lupus Erythematosus (710.*)

Temporomandibular Joint Dysfunction (524.6 *)

Tinnitus (388.**)

Urticaria (708.*)

Vasculitis (various)

Vulvodynia (625.9)

Wilson's Syndrome (275.1)

Signs, Symptoms and Ill-Defined Conditions

Chest Pain (786.5 and others)
Dyspnea and Respiratory Abn. (786.0 and others)

Blurred Vision (368.8)

Dizziness, Vertigo, Equilibrium Disturbance (780.4)

Excess Thirst (783.5)

Flushing (782.62)

Gait, abnormal (781.2)

Involuntary Movements (781.0)

Memory Disturbance (780.9)

Nausea and Vomiting (787.0)

Pain, abdominal (789.0)

Rash (782.1)

Palpitations (785.1)

Skin Sensations, abnormal (782.0)

Sleep Disturbances (780.5 and others,
including Insomnia and Restless Leg Syndrome)

Smell and Taste Disturbances (781.1)

Tachycardia (785.0)

Throat Pain (784.1)

Urinary Frequency (788.41)

Vestibular abnormalities (794.16)

Voice Disturbances (784.4)

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Last Modified: 11/08/06