Neurology & Pain Management Coding Alert

Question: Encounter notes indicate that a patient suffers from “psychogenic aphonia.” What is this condition, and how do I choose an ICD-10 code for it?

Rhode Island Subscriber

Answer: This diagnosis should be coded with F44.4 (Conversion disorder with motor symptom or deficit). Psychogenic aphonia is listed as an alternate term for F44.4, along with:

• Conversion disorder with abnormal movement
• Conversion disorder with speech symptoms
• Conversion disorder with swallowing symptoms
• Conversion disorder with weakness/paralysis
• Dissociative motor disorders
• Psychogenic dysphonia

Wait … there’s more: That’s not the only diagnosis — or list of alternate terms — for patients suffering from conversion disorder. Here’s a look at the other ICD-10 codes for conversion disorder, along with any alternate terms:

• F44.5 (Conversion disorder with seizures or convulsions)

Alternate terms
ο Conversion disorder with attacks or seizures
ο Dissociative convulsions

• F44.6 (Conversion disorder with sensory symptom or deficit)

Alternate terms
ο Conversion disorder with anesthesia or sensory loss
ο Conversion disorder with special sensory symptoms
ο Dissociative anesthesia and sensory loss
ο Psychogenic deafness

• F44.7 (Conversion disorder with mixed symptom presentation)
• F44.81 (Dissociative identity disorder)

Alternate terms
ο Multiple personality disorder

• F44.89 (Other dissociative and conversion disorders)

Alternate terms
ο Ganser’s syndrome
ο Psychogenic confusion
ο Psychogenic twilight state
ο Trance and possession disorders

• F44.9 (Dissociative and conversion disorder, unspecified)

Alternate terms
ο Dissociative disorder NOS.