Abstract

The debate over the diagnostic coding of gaming disorder has largely been framed as a binary dispute over whether such coding should be adopted. However, explicit decision rules remain underdeveloped for determining the empirical conditions under which the current classification should be maintained, reclassified, or withdrawn. This conceptual paper reframes the issue through the principle of falsifiability and proposes a hierarchical decision tree for evaluating the diagnostic coding of gaming disorder. It reviews the history of psychiatric classification and the depathologization of homosexuality and gender incongruence, differences in classification strategies between Internet Gaming Disorder (IGD) in the DSM-5/DSM-5-TR and Gaming Disorder (GD) in the ICD-11, and the major arguments surrounding diagnostic coding. Six evaluative conditions are derived and hierarchically integrated: validity as an independent disorder, measurement validity, causal direction, course of the disorder, clinical utility, and social costs and benefits. A provisional review of these conditions suggests that the evidence supporting gaming disorder as an independent disorder category and the additional practical benefits of diagnostic coding are not yet sufficiently stable. This is not intended as a definitive conclusion for or against coding; rather, the framework clarifies what additional evidence is required and under what conditions existing judgments should be revised. The proposed framework may provide a basis for public deliberation in future reviews of the Korean Standard Classification of Diseases (KCD) and for setting related research agendas.