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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

 

Powerpoint Presentation

 

Slide 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

Picture of Slide 1 as described above, with logo of American Speech-Language-Hearing Association

 

Slide 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

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Slide 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

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Slide 4

Voice Disturbance vs. Resonance Disorder

Voice Disturbance Resonance Disorder
Disorder of phonation
  • Known as "Dysphonia"
 Disorder of resonance and nasal air flow
Symptom of laryngeal disorder
  • Affects structure and/or function of larynx
 Symptom of velopharyngeal dysfunction
  • Affects structure and/or function of oral cavity, nasal airway, and/or the velopharyngeal port
Examples: nodules, polyps, GERD, laryngeal cancer, vocal cord paralysis Examples: cleft palate, submucous cleft, hypertrophied adenoids

 

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Slide 5

Resonance Disorders

  • Hyponasality - diminished nasality
  • Hypernasality - excessive nasality

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Slide 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

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Slide 7

Benefits of the New Codes

  • Clarifies and specifies the disorder
  • Provides a more definitive diagnosis
  • Improves communication between disciplines
  • Facilitates efficient treatment planning

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Slide 8

Proposed Changes to 784.4

  • 784.4 Voice and resonance disorders
    • 784.40 Voice disorder, unspecified
    • 784.41 Aphonia
    • 784.42 Dysphonia, Hoarseness
    • 784.43 Hypernasality
    • 784.44 Hyponasality
    • 784.49 Other voice and resonance disorders

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Slide 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

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Classification Sources

Data Resources

 

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