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ICD-10 Code for Social-Pragmatic Disorder

Dee Adams Nikjeh, PhD, CCC-SLP

September 15, 2015

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Question

I have evaluated an adolescent who has a social pragmatic disorder.  What is an appropriate ICD-9 code and what will the code be when using ICD-10?

 

Answer

Unfortunately, there is not a good code for this scenario.  Even though there are now 68,000 codes to choose from with ICD-10-CM, there will still be times when you do not have that perfect code for what you are treating.  Specifically, I think for SLPs, because we work with so many different diagnoses and disorders, there will continue to be some areas that do not have a specific ICD code.  However, in this scenario, the one thing that you are not treating is the autism itself.  You are treating the speech and language behaviors, and the social pragmatic behaviors that are associated with it.  In this case for ICD-9, 784.59 (Other speech disturbance) might be a good choice.  For ICD-10, because you have a diagnosis of autism, R47.89 (Other speech disturbance) could be used.  
 
Dr. Nikjeh is co-chair of the Health Care Economics Committee of the American Speech Language and Hearing Association (ASHA). She has appeared before the U.S. Dept of Health and Human Services on behalf of ASHA to propose new diagnostic codes and modifications of existing codes for the benefit of speech-language pathologists.  Dr. Nikjeh is an ASHA advisor to the American Medical Association Health Care Practitioner Advisory Committee where she has presented speech-language pathology procedure codes for valuation of professional service.


dee adams nikjeh

Dee Adams Nikjeh, PhD, CCC-SLP

Dr. Nikjeh is co-chair of the Health Care Economics Committee of the American Speech Language and Hearing Association (ASHA). She has appeared before the U.S. Dept of Health and Human Services on behalf of ASHA to propose new diagnostic codes and modifications of existing codes for the benefit of speech-language pathologists.  Dr. Nikjeh is an ASHA advisor to the American Medical Association Health Care Practitioner Advisory Committee where she has presented speech-language pathology procedure codes for valuation of professional service. Her clinical experience spans thirty years.  She provides services for patients of West Coast Ear, Nose and Throat Association specializing in endoscopic procedures for evaluation and management of voice disorders.  Dr. Nikjeh is a consultant for the United States Dept. of Justice, Civil Division-Fraud Section and is an associate of Fearon & Levine, a national consulting firm that focuses on practice management and payment policy in outpatient rehabilitation settings. Dr. Nikjeh is an ASHA Fellow and has served on ASHA's Legislative Council and Executive Board of the Council of State Association Presidents. She is a past-president of the Florida Association of Speech Language Pathologists and Audiologists.


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