# Phonophobia



## pajohnson (Jun 19, 2013)

Does anybody know the correct code for this dx??


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## mitchellde (Jun 19, 2013)

You just have to go under other phobias in the 300.2- section.


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## marvelh (Jun 24, 2013)

Also take a look at 388.42 Hyperacusis  The definition in the ICD-9 book says "Exceptionally acute sense of hearing caused by such conditions as Bell's Palsy; this term may also refer to painful sensitivity to sounds."


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## mitchellde (Jun 25, 2013)

It is not the same thing, be careful as a coder that we do not give a patient a diagnosis that they do not have, a phobia is a fear of something, this is different from a sensitivity to something.


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## marvelh (Jun 25, 2013)

Phonophobia in relationship to migraine headaches is an exaggerated sensitivity to sounds, especially loud noises.  This is similar to photophobia that is reported with ICD-9 code 368.13.  

Per the International Headache Society's guidelines, the diagnosis requirements for migraine without aura include: during the headache, the patient must have at least one of the following: 1. nausea and/or vomiting 2. photophobia and phonophobia.  These guidelines include the following defintions:
Phonophobia: Hypersensitivity to sound, usually causing avoidance.
Photophobia: Hypersensitivity to light, usually causing avoidance.

Phonophobia and photophobia can also be characteristics of other types of headaches as well.


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## mitchellde (Jun 26, 2013)

The definition of hyperacusis put forth by Jastreboff and Hazell has been widely accepted. They stated that hyperacusis is an abnormal sound sensitivity arising from within the auditory system, either peripheral or central. This may explain why there should be some abnormality in the audiological examinations or investigations noted with true hyperacusis 
Phonophobia is defined as a persistent, abnormal, and unwarranted fear of sound. Often, these are normal environmental sounds (e.g., traffic, kitchen sounds, doors closing, or even loud speech) that cannot under any circumstances be damaging. Phonophobia may also be related to, caused by, or confused with hyperacusis, which is an abnormally strong reaction to sound, occurring within the auditory pathways, in levels that would not trouble a normal individual

The poster stated nothing in regards to a migraine, therefore as a coder given only a diagnosis we cannot stretch to reach something that it might also be.  perhaps with additional information the answer would be different but a diagnosis out of context can only be interpreted one way.


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