Multiple Sclerosis F010

Current RMA Instruments
Reasonable Hypothesis SOP
11 of 2020
Balance of Probabilities SOP
12 of 2020
Changes from previous instruments

ICD Coding
  • ICD-9-CM Codes: 340
  • ICD-10-AM Codes: G35
Brief description

Multiple sclerosis is an immune-mediated demyelinating disease of the central nervous system, typically affecting young to middle aged adults.  It causes a range of symptoms, such as muscle weakness, numbness and changes in vision.  The course of the disease is highly variable, but there are often episodes (attacks) of symptoms with partial or complete recovery periods in between.

Confirming the diagnosis

The diagnosis can be relatively straightforward in people who present with typical symptoms and have characteristic MRI findings. In such people the diagnosis may be made at the time of the first attack.  In others the diagnosis can be difficult and may be delayed.  A range of addition investigations may be performed, particularly to rule out other causes for the presentation.  Specialist diagnosis will be routine for this condition.

The relevant medical specialist is a neurologist.

Additional diagnoses covered by SOP
  • Disseminated sclerosis
Conditions not covered by SOP
  • clinically isolated syndrome#
  • radiologically isolated syndrome#
  • neuromyelitis optica#
  • acute disseminated encephalomyelitis#
  • Marburg disease#
  • Balo concentric sclerosis#
  • Schilder disease#

# Non-SOP condition

Clinical onset

The most common presentation is a young adult with one or more distinct episodes of central nervous system dysfunction, with at least partial recovery.  Motor symptoms can include weakness, visual changes, gait disturbance and balance problems.  Sensory symptoms (e.g. numbness) tend to involve the face and limbs.  Diagnois requires both clinical manifestations and imaging findings, but onset may be backdatable to when just clinical manifestations, or just radiological changes (found incidentally) were first noted.

Clinical worsening

The condition can follow a relapsing/remitting course, or be progressive.  The tendency is for a relapsing pattern in the early years, then a progressive decline later on. The rate of worsening is slow in most patients. Worsening may be evidenced by an increase in the frequency or severity of relapses, or an increase in the rate of progression.  Disease modifying therapy is now available for multiple sclerosis.

Source URL: https://clik.dva.gov.au/ccps-medical-research-library/sops-grouped-icd-body-system/m/multiple-sclerosis-f010-g35

Last amended

Rulebase for multiple sclerosis

<h5>Current RMA Instruments</h5><table border="1" cellpadding="1" cellspacing="1"><tbody><tr><td><address><a href="http://www.rma.gov.au/assets/SOP/2020/011.pdf&quot; target="_blank">Reasonable Hypothesis SOP</a></address></td><td>11 of 2020</td></tr><tr><td><address><a href="http://www.rma.gov.au/assets/SOP/2020/012.pdf&quot; target="_blank">Balance of Probabilities SOP </a></address></td><td>12 of 2020</td></tr></tbody></table><h5>Changes from previous instruments</h5><p><drupal-media data-entity-type="media" data-entity-uuid="4a3ff864-c32b-4e5a-846b-2fae13366687" data-view-mode="wysiwyg"></drupal-media></p><h5>ICD Coding</h5><ul><li>ICD-9-CM Codes: 340</li><li>ICD-10-AM Codes: G35</li></ul><h5>Brief description</h5><p>Multiple sclerosis is an immune-mediated demyelinating disease of the central nervous system, typically affecting young to middle aged adults.  It causes a range of symptoms, such as muscle weakness, numbness and changes in vision.  The course of the disease is highly variable, but there are often episodes (attacks) of symptoms with partial or complete recovery periods in between.</p><h5>Confirming the diagnosis</h5><p>The diagnosis can be relatively straightforward in people who present with typical symptoms and have characteristic MRI findings. In such people the diagnosis may be made at the time of the first attack.  In others the diagnosis can be difficult and may be delayed.  A range of addition investigations may be performed, particularly to rule out other causes for the presentation.  Specialist diagnosis will be routine for this condition.</p><p>The relevant medical specialist is a neurologist.</p><h5><strong>Additional diagnoses covered by SOP</strong></h5><ul><li>Disseminated sclerosis</li></ul><h5><strong>Conditions not covered by SOP</strong></h5><ul><li>clinically isolated syndrome<span lang="EN" xml:lang="EN"><sup>#</sup></span></li><li>radiologically isolated syndrome<span lang="EN" xml:lang="EN"><sup>#</sup></span></li><li>neuromyelitis optica<span lang="EN" xml:lang="EN"><sup>#</sup></span></li><li>acute disseminated encephalomyelitis<span lang="EN" xml:lang="EN"><sup>#</sup></span></li><li>Marburg disease<span lang="EN" xml:lang="EN"><sup>#</sup></span></li><li>Balo concentric sclerosis<span lang="EN" xml:lang="EN"><sup>#</sup></span></li><li>Schilder disease<span lang="EN" xml:lang="EN"><sup>#</sup></span></li></ul><p><sup><span lang="EN" xml:lang="EN">#</span></sup> Non-SOP condition</p><h5>Clinical onset</h5><p>The most common presentation is a young adult with one or more distinct episodes of central nervous system dysfunction, with at least partial recovery.  Motor symptoms can include weakness, visual changes, gait disturbance and balance problems.  Sensory symptoms (e.g. numbness) tend to involve the face and limbs.  Diagnois requires both clinical manifestations and imaging findings, but onset may be backdatable to when just clinical manifestations, or just radiological changes (found incidentally) were first noted.</p><h5>Clinical worsening</h5><p>The condition can follow a relapsing/remitting course, or be progressive.  The tendency is for a relapsing pattern in the early years, then a progressive decline later on. The rate of worsening is slow in most patients. Worsening may be evidenced by an increase in the frequency or severity of relapses, or an increase in the rate of progression.  Disease modifying therapy is now available for multiple sclerosis.</p>

Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/m/rulebase-multiple-sclerosis

Inability to obtain appropriate clinical management for multiple sclerosis

Current RMA Instruments
Reasonable Hypothesis SOP
11 of 2020
Balance of Probabilities SOP
12 of 2020
Changes from previous instruments

ICD Coding
  • ICD-9-CM Codes: 340
  • ICD-10-AM Codes: G35
Brief description

Multiple sclerosis is an immune-mediated demyelinating disease of the central nervous system, typically affecting young to middle aged adults.  It causes a range of symptoms, such as muscle weakness, numbness and changes in vision.  The course of the disease is highly variable, but there are often episodes (attacks) of symptoms with partial or complete recovery periods in between.

Confirming the diagnosis

The diagnosis can be relatively straightforward in people who present with typical symptoms and have characteristic MRI findings. In such people the diagnosis may be made at the time of the first attack.  In others the diagnosis can be difficult and may be delayed.  A range of addition investigations may be performed, particularly to rule out other causes for the presentation.  Specialist diagnosis will be routine for this condition.

The relevant medical specialist is a neurologist.

Additional diagnoses covered by SOP
  • Disseminated sclerosis
Conditions not covered by SOP
  • clinically isolated syndrome#
  • radiologically isolated syndrome#
  • neuromyelitis optica#
  • acute disseminated encephalomyelitis#
  • Marburg disease#
  • Balo concentric sclerosis#
  • Schilder disease#

# Non-SOP condition

Clinical onset

The most common presentation is a young adult with one or more distinct episodes of central nervous system dysfunction, with at least partial recovery.  Motor symptoms can include weakness, visual changes, gait disturbance and balance problems.  Sensory symptoms (e.g. numbness) tend to involve the face and limbs.  Diagnois requires both clinical manifestations and imaging findings, but onset may be backdatable to when just clinical manifestations, or just radiological changes (found incidentally) were first noted.

Clinical worsening

The condition can follow a relapsing/remitting course, or be progressive.  The tendency is for a relapsing pattern in the early years, then a progressive decline later on. The rate of worsening is slow in most patients. Worsening may be evidenced by an increase in the frequency or severity of relapses, or an increase in the rate of progression.  Disease modifying therapy is now available for multiple sclerosis.

Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/m/multiple-sclerosis-f010-g35/rulebase-multiple-sclerosis/inability-obtain-appropriate-clinical-management-multiple-sclerosis

Infection with Epstein-Barr virus

Current RMA Instruments
Reasonable Hypothesis SOP
11 of 2020
Balance of Probabilities SOP
12 of 2020
Changes from previous instruments

ICD Coding
  • ICD-9-CM Codes: 340
  • ICD-10-AM Codes: G35
Brief description

Multiple sclerosis is an immune-mediated demyelinating disease of the central nervous system, typically affecting young to middle aged adults.  It causes a range of symptoms, such as muscle weakness, numbness and changes in vision.  The course of the disease is highly variable, but there are often episodes (attacks) of symptoms with partial or complete recovery periods in between.

Confirming the diagnosis

The diagnosis can be relatively straightforward in people who present with typical symptoms and have characteristic MRI findings. In such people the diagnosis may be made at the time of the first attack.  In others the diagnosis can be difficult and may be delayed.  A range of addition investigations may be performed, particularly to rule out other causes for the presentation.  Specialist diagnosis will be routine for this condition.

The relevant medical specialist is a neurologist.

Additional diagnoses covered by SOP
  • Disseminated sclerosis
Conditions not covered by SOP
  • clinically isolated syndrome#
  • radiologically isolated syndrome#
  • neuromyelitis optica#
  • acute disseminated encephalomyelitis#
  • Marburg disease#
  • Balo concentric sclerosis#
  • Schilder disease#

# Non-SOP condition

Clinical onset

The most common presentation is a young adult with one or more distinct episodes of central nervous system dysfunction, with at least partial recovery.  Motor symptoms can include weakness, visual changes, gait disturbance and balance problems.  Sensory symptoms (e.g. numbness) tend to involve the face and limbs.  Diagnois requires both clinical manifestations and imaging findings, but onset may be backdatable to when just clinical manifestations, or just radiological changes (found incidentally) were first noted.

Clinical worsening

The condition can follow a relapsing/remitting course, or be progressive.  The tendency is for a relapsing pattern in the early years, then a progressive decline later on. The rate of worsening is slow in most patients. Worsening may be evidenced by an increase in the frequency or severity of relapses, or an increase in the rate of progression.  Disease modifying therapy is now available for multiple sclerosis.

Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/m/multiple-sclerosis-f010-g35/rulebase-multiple-sclerosis/infection-epstein-barr-virus

Inhaling or having cutaneous contact with organic solvents

Current RMA Instruments
Reasonable Hypothesis SOP
11 of 2020
Balance of Probabilities SOP
12 of 2020
Changes from previous instruments

ICD Coding
  • ICD-9-CM Codes: 340
  • ICD-10-AM Codes: G35
Brief description

Multiple sclerosis is an immune-mediated demyelinating disease of the central nervous system, typically affecting young to middle aged adults.  It causes a range of symptoms, such as muscle weakness, numbness and changes in vision.  The course of the disease is highly variable, but there are often episodes (attacks) of symptoms with partial or complete recovery periods in between.

Confirming the diagnosis

The diagnosis can be relatively straightforward in people who present with typical symptoms and have characteristic MRI findings. In such people the diagnosis may be made at the time of the first attack.  In others the diagnosis can be difficult and may be delayed.  A range of addition investigations may be performed, particularly to rule out other causes for the presentation.  Specialist diagnosis will be routine for this condition.

The relevant medical specialist is a neurologist.

Additional diagnoses covered by SOP
  • Disseminated sclerosis
Conditions not covered by SOP
  • clinically isolated syndrome#
  • radiologically isolated syndrome#
  • neuromyelitis optica#
  • acute disseminated encephalomyelitis#
  • Marburg disease#
  • Balo concentric sclerosis#
  • Schilder disease#

# Non-SOP condition

Clinical onset

The most common presentation is a young adult with one or more distinct episodes of central nervous system dysfunction, with at least partial recovery.  Motor symptoms can include weakness, visual changes, gait disturbance and balance problems.  Sensory symptoms (e.g. numbness) tend to involve the face and limbs.  Diagnois requires both clinical manifestations and imaging findings, but onset may be backdatable to when just clinical manifestations, or just radiological changes (found incidentally) were first noted.

Clinical worsening

The condition can follow a relapsing/remitting course, or be progressive.  The tendency is for a relapsing pattern in the early years, then a progressive decline later on. The rate of worsening is slow in most patients. Worsening may be evidenced by an increase in the frequency or severity of relapses, or an increase in the rate of progression.  Disease modifying therapy is now available for multiple sclerosis.

Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/m/multiple-sclerosis-f010-g35/rulebase-multiple-sclerosis/inhaling-or-having-cutaneous-contact-organic-solvents