The ASHA Leader - September 21, 2010 - (Page 8)

New Fluency, Cognition Diagnosis Codes ICD-9-CM Changes Take Effect Oct. 1 For the first time these codes capture a spectrum of cognitive disorders associated with conditions—such as traumatic brain injury (TBI)—classified elsewhere. by Steven White ew codes in the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM), include important changes for speechlanguage pathology diagnoses related to fluency disorders and cognitive communication. The changes appear in 2010 ICD-9-CM addenda that become effective Oct. 1, 2010 (www.cdc.gov/ nchs/icd/icd9cm_addenda_guidelines.htm). The new fluency codes follow extensive lobbying by ASHA (The ASHA Leader, Nov. 25, 2008). The fluency proposal was first presented at the ICD-9-CM Coordination and Maintenance Committee meeting in September 2008 and a revised proposal was presented at the September 2009 meeting (details about the presentations are available at www.cdc.gov/nchs/icd/ icd9cm_maintenance.htm). Following negotiations on the best placement of the fluency codes, the final revised proposal was N • 307.0—Under the new regulations, ICD-9-CM 307.0 will no longer be used as the default code for stuttering. Instead, 307.0 will be used to describe adult-onset fluency disorder not caused by stuttering that arises from other well-described organic conditions, such as stroke or Parkinson’s disease. In effect, the 307.0 will be used to identify stuttering that may be “psychogenic” in origin. presented in March 2010; it recommended additions • 315.35—A new code, 315.35, will be used to report and revisions to the ICD-9-CM to “better capture the childhood-onset fluency disorder, regardless of the nature and description of fluency disorders.” current age of the client. The new code will become the default code for a disorder related to fluency. Fluency The addenda indicate that the code should be used ASHA presented the final recommendations for for cluttering, fluency disorder, and stammering. the fluency coding revision in collaboration with the ASHA will offer guidance to help providers and American Psychiatric Association. Nan Bernstein families seek coverage if carriers inappropriately Ratner led the effort with support from the ASHA exclude coverage in response to this code (as they Health Care Economics Committee. The addenda sometimes respond to other conditions coded in the include the following changes: 315 series). • 438.14—A revised code, Table 1. Fluency changes and revisions 438.14, is already available for Changes to fluency disorder diagnostic codes appear in three ICD-9-CM chapters: Mental Disorders (“Special symptoms or syndromes, not classified fluency disorder or stuttering due elsewhere,” 290-319), Diseases of the Circulatory System (390-459), and Signs, Symptoms, and Ill-Defined Conditions (780-799). This chart reflects to late effect of cerebrovascular the changes in these diagnostic codes. accident. • 784.5—A new code, 784.5 Code Addition Changes (other speech disturbance), will 307.0 • Excludes: childhood-onset fluency disorder (315.35) • New name: Adult-onset fluency disorder (formerly be added to the “Ill-Defined • Excludes: fluency disorder in conditions classified elsewhere Stuttering) (784.52) • Changes exclusion to “fluency disorder due to Conditions” chapter under 784, late effect of cerebrovascular accident (438.14)” symptoms involving head and [formerly “stuttering (fluency disorder) due to late neck. effect of cerebrovascular accident (438.14)”] • 784.52—A new code, 315.35 (new code) 315.35, Childhood onset fluency disorder (cluttering not otherwise 784.52, will be in place for specified, stuttering not otherwise specified) “fluency disorder in conditions Excludes: • Adult onset fluency disorder (307.0) classified elsewhere” under • Fluency disorder due to late effect of cerebrovascular “other speech disturbance.” It accident (438.14) will exclude 307.0, 315.35, and • Fluency disorder in conditions classified elsewhere (784.52) 438.14. This code should be 315.39 Other (in 315.3, Delete “Excludes: stammering and stuttering (307) used when stuttering appears as developmental speech or language a symptom of another condition, disorder) such as following closed-head 438.14, Fluency disorder (in 438, Revise: Stuttering due to late effect of cerebrovascular injury or as part of the sympaccident Late effects of cerebrovascular disease) toms of Parkinson’s disease; the fluency disorder is not a pre784.5, Other speech disturbance • Changes “Excludes: stammering and stuttering (in 784, Symptoms involving head (315.35)” to “Excudes: stuttering (315.35) existing condition, but rather is and neck ) • Delete “Excludes: that of nonorganic origin (307.0, a symptom of another condition 307.9)” also being coded as the major 784.52 (new code) 784.52, Fluency disorder in conditions classified elsewhere, diagnosis. stuttering in conditions classified elsewhere [code first underlying For additional fluency revidisease or condition, such as Parkinson’s disease (332.0)]. Excludes: adult onset fluency disorder (307.0); childhood onset sions, see Table 1 (left). fluency disorder (315.35); fluency disorder due to late effect of cerebrovascular accident (438.14) 8 September 21, 2010 http://www.cdc.gov/nchs/icd/icd9cm_addenda_guidelines.htm http://www.cdc.gov/nchs/icd/icd9cm_addenda_guidelines.htm http://www.cdc.gov/nchs/icd/icd9cm_maintenance.htm http://www.cdc.gov/nchs/icd/icd9cm_maintenance.htm

Table of Contents for the Digital Edition of The ASHA Leader - September 21, 2010

The ASHA Leader - September 21, 2010
Contents
Teens at Risk: "We're on the Edge of an Epidemic"
Bottom Line
Audiology
New Fluency, Cognition Diagnosis Codes
Schools 2010: Learning and Leadership in Las Vegas
RTI Progress-Monitoring Tools
Classroom Acoustics: What Possibly Could Be New?
Schools Practice: New Research and Online Resources
From the President
Schools Survey Caseload Data
Internet
Identification and Treatment of Landau-Kleffner Syndrome
Buyers Guide
Classifieds
First Person on the Last Page

The ASHA Leader - September 21, 2010