# language barrier



## cpccoder2008 (Feb 4, 2011)

what is the diagnosis for a patient who comes in and does not speak english ? My providers are putting language barrier at the diagnosis but i cannot find an ICD-9 code for this. Thanks


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## tefranklin57 (Feb 4, 2011)

I can not find a foreign language diagnosis code either, but you can use additional E/M  prolonged service 99354 if the criteria is met.


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## ohn0disaster (Feb 4, 2011)

*Not sure I'd try to code "language barrier" as a diagnosis, at all*

The only code that I could find that would even, remotely, possibly be suitable as a dx code for "language barrier" is V40.1, *Problems with communication [including speech]*. Hopefully someone else can come up with something better?


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## FTessaBartels (Feb 4, 2011)

*Is this really the reason for the visit?*

This is really not a medical diagnosis.  I would not code it. 

I would code only what brought the patient to see the physician ... e.g. chest pain, diarrhea, URI, etc.

Hope that helps.

F Tessa Bartels, CPC, CEMC


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## NaliniAAPC (Feb 4, 2011)

Hi,

Yes Tessa is correct, this is not a medical diagnosis. I also would not code it.

Regards,
Nalini CPC


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## cpccoder2008 (Feb 7, 2011)

No its not the main problem they are coming in but it does affect their care. There are pregancy patients and most of them cannot speak english so the doctor will put something like late prenatal care due to language barrier or inadequate prenatal care due to language barrier, these patients have a hard time understanding therefore don't always complete their care or follow instructions. I had one patient who had a STD and continued to have UTI's through out her whole pregnancy. The doctor explained to her many times that until her partner got treated she would continue to have these problems and on his progress note he wrote " +CT with history of UTI's due to language barrier" I wouldn't code this as a primary dx i would use it last just as an additional code to explain the situation. He documents this on every progress not along with any op reports.


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## ValSue (May 6, 2013)

The best code I can find is V49.89 which falls under Other conditions influencing health status/Other specified conditions influencing health status. I considered V41.8, but the patient can speak, just not be understood unless there's a translation.

If someone comes up with something better - please post it!

Here's a link with hundreds of articles about how language barriers affect patient care. I think it's important enough to start tracking. Unfortunately, I'm starting to see physician documentation with language barrier issues - and grammar, spelling, and punctuation as well!
http://scholar.google.com/scholar?q...a=X&ei=MbSHUeGOHqX84AON8ICICQ&ved=0CCkQgQMwAA


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## MUSBEJO (Mar 18, 2014)

*Language barrier influencing health*

I would go with a V-code for factors influencing health as cultural; so I coded V62.4.


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