Gastroenterology Coding Alert

Question: How should I code the treatment procedure for difficulty in swallowing (dysphagia)?

Montana Subscriber

Answer: The CPT 92526 (Treatment of swallowing dysfunction and/or oral function for feeding) almost always fits most aspects of treatments associated with dysphagia (787.2X) related to any of the upper throat mechanics. This lone code is all you need when the focus of the treatment is for swallowing. It is an untimed code, billed as 1 unit per day.

Update: There is now a fifth digit dividing the types of dysphagia. Several ICD-9 codes allow speech-langueage pathologists (SLPs) to provide an appropriate dysphagia diagnosis, i.e.:

• 787.20 -- Dysphagia, unspecified
• 787.21 -- Dysphagia, oral phase
• 787.22 --- Dysphagia, oropharyngeal phase
• 787.23 --  Dysphagia, pharyngeal phase
• 787.24 --  Dysphagia, pharyngoesophageal phase
• 787.29 -- Other dysphagia

Quick fact: Physicians normally direct patients who complain about any type of upper throat swallowing problem to a SLP for an appropriate swallow evaluation. SLPs are the ones who actually diagnose dysphagia, determine what type and develop a treatment plan.