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Voice, Resonance, and Stuttering Disorders ICD-9-CM Recommendations. Dee Adams Nikjeh, PhD, CCC-SLP Ear, Nose & Throat Associates, Clearwater FL Research Assistant Professor, University of South Florida September 25, 2008. Proposal for Changes to ICD-9-CM.

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Voice resonance and stuttering disorders icd 9 cm recommendations l.jpg

Voice, Resonance, and Stuttering Disorders ICD-9-CM Recommendations

Dee Adams Nikjeh, PhD, CCC-SLP Ear, Nose & Throat Associates, Clearwater FL

Research Assistant Professor, University of South Florida

September 25, 2008


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Proposal for Changes to ICD-9-CM

Chapter 16: Symptoms, Signs, and Ill-Defined Conditions (780-799)

(784) Symptoms involving head and neck

784.4 Voice Disturbance

2 American Speech-Language-Hearing Association


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Current Listing in ICD-9-CM

784.4 Voice disturbances

704.40 Voice disturbance, unspecified

784.41 Aphonia, loss of voice

784.49 Other

Change in voice Hypernasality

Dysphonia Hyponasality

Hoarseness

3 American Speech-Language-Hearing Association


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Voice Disturbance

Disorder of phonation

Known as “Dysphonia”

Symptom of laryngeal disorder

Affects structure and/or function of larynx

Examples: nodules, polyps, GERD, laryngeal cancer, vocal cord paralysis

4

Resonance Disorder

Disorder of resonance and nasal air flow

Symptom of velopharyngeal dysfunction

Affects structure and/or function of oral cavity, nasal airway, and/or the velopharyngeal port

Examples: cleft palate, submucous cleft, hypertrophied adenoids

American Speech-Language-Hearing Association

Voice Disturbance vs. Resonance Disorder


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Resonance Disorders

Hyponasality – diminished nasality

Hypernasality – excessive nasality

5 American Speech-Language-Hearing Association


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Why Revise the Code?

Dysphonia is a disorder of phonation

Dysphonia is distinct and separate from a disorder of resonance and nasal air flow

Evaluation techniques and management strategies are different for disorders of phonation versus resonance

6 American Speech-Language-Hearing Association


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Benefits of the New Codes

Clarifies and specifies the disorder

Provides a more definitive diagnosis

Improves communication between disciplines

Facilitates efficient treatment planning

7 American Speech-Language-Hearing Association


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Proposed Changes to 784.4

784.4 Voice and resonance disorders

784.40 Voice disorder, unspecified

784.41 Aphonia

784.42 Dysphonia

Hoarseness

784.43Hypernasality

784.44Hyponasality

784.49 Other voice and resonance disorders

8 American Speech-Language-Hearing Association


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By the Way…Current ICD-10-CM (July 2007)

R49 Voice disturbances

Excludes1: psychogenic voice disturbance (F44.4)

R49.0 Dysphonia

Hoarseness

R49.1 Aphonia

Loss of voice

R49.2 Hypernasality and Hyponasality

R49.21 Hypernasality

R49.22 Hyponasality

R49.8 Other voice disturbances

R49.9 Unspecified voice disturbances

Change in voice NOS

9 American Speech-Language-Hearing Association


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