Otolaryngology Coding Alert

Question: What is the best diagnosis code for laryngopharyngeal reflux (LPR)?

Alabama Subscriber

Answer: Coders have debated in the past whether the better ICD-9 code for this was 530.81 (Esophageal reflux) or 478.79 (Other diseases of larynx, not elsewhere classified). Supporters of 478.79 said that the code for GERD (530.81) did not specify the larynx and pharynx. Supporters of 530.81, however, pointed out that medical references state that LPR is a form of gastroesophageal reflux disease that produces prominent symptoms and signs in the pharynx and larynx characterized by acute, chronic, and intermittent laryngitis and pharyngitis. They said this explanation helped substantiate 530.81.

Now, with ICD-10, diagnosis 478.79 translates to J38.7 (Other diseases of larynx) and 530.81 shifts to K21.9 (Gastro-esophageal reflux disease without esophagitis).

Your best tactic is to study your physician’s documentation to determine which diagnosis is a better fit. If you cannot decide for yourself, bring both options to your provider for input.