ICD-10 in Speech-Language Pathology: An Example

We are well into the era of ICD-10, and while most practices and healthcare groups have gotten the coding system fairly well in hand by now, there are always questions regarding accuracy and specificity with the complex coding structure. This is especially apparent when the topic of ICD-10 for speech-language pathology comes to bear. 

The greatest distinction between ICD-9 and ICD-10 has been that ICD-9 was characterized by the more applicable codes that can be applied to a patient’s case, the better. Well, in ICD-10 less is more, so you want to try and assign only the codes that most accurately and specifically characterize the patient’s dysfunctions and issues. To help you or your fellow SLPs, here is a quick example—with some related codes—for using ICD-10 in speech-language pathology.

A Patient with an Autistic Disorder

The patient is a four-year-old male who presents with the following conditions:

• Nonverbal, with the exception of some echolalia
• Age-appropriate receptive language skills
• Limited expressive language skills (he uses a simple picture system to express his basic needs)
• Sensory issues and eating resistance

The Codes Used for This Case

Primary Code

• F84.0 for autistic disorder

Additional Codes

These codes indicate the reasons for outpatient therapy:

• F80.1 for expressive language disorder
• R48.8 for other symbolic dysfunctions
• R63.3 for feeding difficulties

Description Synonyms for ICD-10 Codes in Speech Therapy

What’s in a name? Well, when it comes to ICD-10, it’s everything. We made this example pretty simple, but keep in mind that we chose the ICD-10 code title (i.e., the name of the code itself) to describe and code for the patient’s condition. However, every code in this scenario has multiple alternative names to describe the same underlying concept. These alternatives—called description synonyms—exist to help providers search for the ICD-10 code that best fits the condition. Here are the description synonyms for the codes in this example:

Autistic Disorder

The description synonyms for F84.0 are:

1. Active infantile autism
2. Autism disorder
3. Autism disorder, residual state
4. Autism, childhood onset
5. Autism, infantile
6. Autism, infantile, active
7. Autism, residual
8. Autistic disorder of childhood onset
9. Childhood psychosis
10. Psychosis in early childhood
11. Psychosis with origin in childhood
12. Psychosis, childhood, current or active state
13. Psychosis, early child
14. Psychosis, early childhood
15. Residual infantile autism

Expressive Language Disorder

The description synonyms for F80.1 are:

1. Developmental expressive language delay
2. Developmental expressive language disorder
3. Expressive developmental language delay
4. Expressive language delay
5. Expressive language delay, mild
6. Expressive language delay, moderate
7. Expressive language delay, severe
8. Language disorder, expressive
9. Mild expressive language delay
10. Moderate expressive language delay
11. Severe expressive language delay

The expressive language disorder (F80.1) is part of a greater list pertaining to Speech Delay ICD-10 diagnosis codes. These include developmental delays due to hearing loss of expressive-receptive disorders. A full list of speech delay ICD-10 codes can be found in this resource.

Other Symbolic Dysfunctions

The description synonyms for R48.8 are:

1. Aphasia, angular gyrus syndrome
2. Aphasia-angular gyrus syndrome
3. Gerstmann syndrome

Feeding Difficulties

The description synonyms for R63.3 are:

1. Developmental delay in feeding
2. Developmental delay, feeding
3. Feeding delay, developmental

Other ICD-10 Speech Therapy Codes

Although not listed in this specific example, we felt it wise to include some other common codes found with ICD-10 for speech-language pathology:

• Expressive aphasia, R47.01;
• Dysphagia, oral phase, R13.11;
• Dysphagia, oropharyngeal phase, R13.12; and
• Apraxia, R48.2.

CPT Codes for Speech-Language Pathology Evaluations

Once the specific and correct diagnosis codes are ready to be assigned do not forget there are specific CPT codes that will fit best for these ICD-10 codes. We have a more complete resource on the best CPT codes available for speech-language pathologists (SLPs) to use, but in the meantime remember that the ICD-10 code must reflect the most accurate and specific reflection of the patient’s dysfunction and the evaluation CPT codes used by SLPs oftentimes reflect this.

Frequently Asked Questions

When dealing with ICD-10 in speech therapy, there are always additional questions. So, to help you out here are some additional answers.

What is the ICD-10 code for speech and language development?

The ICD-10 grouping for F80 has several applicable codes for speech and language development disorders.

What is the ICD-10 code for developmental expressive language disorder?

For this more specific question, the ICD-10 code F80.1, expressive language disorder, fits best.

What Is the ICD-10 code for speech processing disorder?

This common question is a bit vague in its context, but several ICD-10 codes can apply. Some of these codes include: 

• F80.9, Developmental disorder of speech and language, unspecified, 
• H93.25, Central auditory processing disorder, or 
• R47.89, Other speech disturbances.

Please be advised that two of these codes use vague descriptions with the verbiage “unspecified” or “other”. Some insurances may not recognize these as billable for speech therapy services, so further investigation may be warranted.

If these examples seem overwhelming, you’re not alone. Try to keep in mind that ICD-10 for speech-language pathology—and all disciplines—is meant to provide accuracy and transparency for improved quality of care and care coordination. If you could use a few more resources on ICD-10 codes for speech therapists, check out this guide or our ultimate ICD-10 faq.