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

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

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  1. 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

  2. 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

  3. 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

  4. 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

  5. Resonance Disorders Hyponasality – diminished nasality Hypernasality – excessive nasality 5 American Speech-Language-Hearing Association

  6. 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

  7. 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

  8. 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

  9. 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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