ASHA Recommends Revisions to International Classification of Diseases

ASHA members presented recommendations, September 29, on behalf of the Association for additions and revisions in hearing and swallowing diagnoses in the International Classification of Diseases, 9 Revision, Clinical Modification (ICD-9-CM). The ICD-9-CM is the code set required by the Health Insurance Portability and Accountability Act (HIPAA) for reporting diagnoses and disorders.

Audiologist Kyle Dennis and speech-language pathologist Dee Adams Nikjeh made the recommendations at the ICD-9-CM Coordination and Maintenance Committee meeting at the Center for Medicare and Medicare Services central office in Baltimore. The ASHA Health Care Economics Committee developed the new and revised diagnoses along with input from association special interest divisions. The American Academy of Audiology also responded to the recommendations and provided substantive suggestions.

The major hearing proposal was for tabular modifications in category 389, Hearing Loss, to build on new codes implemented October 1 for sensorineural hearing loss. These include new codes for bilateral, unilateral, and asymmetrical hearing loss for the other subcategories in this category, such as conductive hearing loss.

ASHA recommended a code or codes for speech and language developmental delay due to hearing loss to distinguish this diagnosis from developmental speech and language delays.

A code was proposed for acquired auditory processing disorder and the ICD-9-CM committee was asked to revise the descriptor of code 389.7, currently "deaf mutism, not elsewhere classifiable" and replace it with "deaf nonspeaking" because it is a more accurate description. A code also was recommended for dual sensory impairment, deaf-blindness, or multi-sensory impairment.

A supplemental code was suggested for hearing conservation to differentiate hearing conservation and occupational hearing tests from V70.5, Health Examination of Defined Subpopulations.

A supplemental code also was recommended for disability examinations because other codes such as that for examination for medical and legal reasons do not specifically cite disability examination, while V70.5, health examination for defined subpopulations, identifies a wide array of subpopulations included armed forces personnel, prisoners, preschool children, students, refugees, and prostitutes.

A request for more specific codes for dysphagia was made. There is a need for unique codes specific to each phase of dysphagia which includes: oral, oropharyngeal, pharyngeal, and pharyngoesophageal.

For more information about the ICD-9-CM codes, contact Steven White, ASHA's Director of Health Care Economics and Advocacy, by e-mail at swhite@asha.org or by phone at 301-897-0126.

Reprinted with ASHA's permission from www.asha.org/about/legislation-advocacy/2006/ASHArecICD.htm