Neurology & Pain Management Coding Alert

Question: What ICD-9 code should I use for a patient being treated for dysarthria after a cerebrovascular accident (CVA)?

Wisconsin Subscriber

Answer: ICD-9 2010 has new code 438.13 (Late effects of cerebrovascular disease; dysarthria), which specifically addresses this particular problem.

Prior to this change, speech and language deficits with no specific code were lumped together under 438.19 (Other speech and language deficits).

Dysarthria is a motor speech disorder caused by a weakening of the muscles of the mouth, face, and respiratory system. The new ICD-9 code should be reported when this speech disorder is a result of a stroke.A stroke patient with dysarthria will speak softly and slowly, with slurring and changes in vocal quality.

Aside from dysarthria, another code included for 2010 is 438.14 (Late effects of cerebrovascular disease; fluency disorder) for fluency disorders, such as stuttering, an interruption in the flow of speaking that significantly interferes with communication. Use this new ICD-9 code should when patients have fluency disorders as a late effect of a CVA.