Otolaryngology Coding Alert

ICD-10 adds one more option for consideration. 

Xerostomia, or dry mouth, is a condition in which the salivary glands don’t produce enough saliva to keep the mouth wet. Dry mouth can cause difficulties in tasting, chewing, swallowing, and speaking, and may cause infections of the mouth. 

Current coding: When using the ICD-9-CM code set, you report 527.7 (Disturbance of salivary secretion) for patients diagnosed with dry mouth condition. 

ICD-10 changes: You’ll add another possibility to your coding options when ICD-10 becomes effective in October. The new system expands 527.7 into two codes: 

• K11.7 – Disturbances of salivary secretion
  
• R68.2 – Dry mouth, unspecified.
  

Documentation basics: Providers should base their diagnosis of xerostomia on evidence obtained from the patient’s history, an examination of the oral cavity and/or sialometry, a simple office procedure that measures the flow rate of saliva. Your physician should point to this diagnosis if the patient complains of dry mouth, particularly at night, or of difficulty eating dry foods such as crackers. 

Some payers will consider the administration of amifostine medically reasonable and necessary to reduce the incidence of moderate to severe xerostomia in patients undergoing radiation treatment for head and neck cancers. 

Coder tips: In cases where radiation treatment causes xerostomia, you would report the appropriate head and neck cancer codes in addition to K11.7 and L59.9 (Disorder of the skin and subcutaneous tissue related to radiation, unspecified). Check your payer policies to get the final word on which codes they require on the claim for payment.