Otolaryngology Coding Alert

Question: I recently started working with an ENT who brought this question to me. Previous notes on a patient were from 2010 and documented laryngopharyngeal reflux (LPR). Because a patient can have LPR without gastroesophageal reflux (GERD), my doc tor says he’s had a problem using 530.81 because the primary care physician had documented that the patient does not have common reflux. Would 478.79 be an appropriate diagnosis?

Florida Subscriber

Answer: There is no separate diagnosis code for laryngopharyngeal reflux, which means coders turn to different options for their claims. Most physicians use the diagnosis of GERD for their LPR patients.

Diagnosis 478.79 (Other diseases of larynx) only refers to ulcers, abscesses, etc., but does not specifically refer to reflux. Another option is 530.81 (Esophageal reflux), which represents GERD but isn’t necessarily accurate for some patients. Unfortunately, ICD-9 has not presented coders good options to code LPR. When we convert to ICD-10-CM in October 2014, Barbara J. Cobuzzi, MBA, CPC, CPC-H, CPC-P, CPC-I, CENTC, CHCC, recommends J39.8 (Other specified diseases of upper respiratory tract) for LPR. It is frustrating that even ICD-10 does not have a more specific diagnosis for LPR.