ICD-10 Dysphagia – What is Dysphagia?
Dysphagia is a condition that represents difficulty in swallowing. Food or liquid takes more time and effort to swallow and reach the stomach. Swallowing is either painful or impossible.
What are the symptoms of Dysphagia?
Dysphagia is usually associated with several conditions. However, the following symptoms indicate Dysphagia regardless of its cause:
- Inability to swallow or difficulty in swallowing
- Weight loss due to malnutrition
- Hoarseness in voice
- Regurgitation of food
- Problems in breathing
ICD-10 Coding for Dysphagia:
World Health Organization (WHO) approves a coding system to document diseases, their diagnosis, treatments, and billing. This coding system is widely used in many states. ICD-10 is an updated coding system, and it covers a large number of medical conditions.
Dysphagia and its associated diagnosis code:
ICD-10 codes for Dysphagia are used by healthcare providers who work with patients with difficulty swallowing. The codes are different for adults and children. According to the American Speech Language Hearing Association (ASHA), Dysphagia can be categorized as Speech, Language, and Swallowing disorders.
This category excludes Dysphagia resulting from traumatic brain injury, spinal cord injury, or cerebrovascular disease. This category follows the R13.1 dysphagia code:
R13.10- Unspecified Dysphagia
R13.11- Oral phase Dysphagia ( this refers to the complications in food or liquid control in the mouth. Lips and tongue movement are also compromised in some cases).
R13.12- Oropharyngeal phase Dysphagia (also termed transfer dysphagia) refers to difficulty initiating swallowing. It occurs most of the time due to some neurological disorders.
R13.13- Pharyngeal phase dysphagia (problems in the throat while swallowing).
R13.14- Pharyngeoesophageal phase dysphagia
R13.19- Other dysphagia (Cervical and Neurogenic)
Some other codes indicating Dysphagia due to brain or spinal cord injury are categorized as follows:
I69.091- Dysphagia following nontraumatic subarachnoid hemorrhage (usually due to a ruptured aneurysm and bleeding within the subarachnoid space)
I69.191- Dysphagia following nontraumatic intracerebral hemorrhage (due to hypertensive damage to the blood vessels in the brain or stroke).
I69.291- Dysphagia following other nontraumatic intracranial hemorrhages
I69.391- Dysphagia following cerebral infarction (due to disrupted blood flow leading to necrosis of the brain tissue).
I69.891- Dysphagia following other cerebrovascular diseases
I69.991- Dysphagia following unspecified cerebrovascular disease
Other conditions associated with Dysphagia can be coded as follows:
R13.0- Aphagia (complete loss of ability to swallow).
Some neoplasms making swallowing difficult are coded as:
C01- Malignant neoplasm of the base of the tongue (making swallowing difficult as a symptom)
C02.9- Unspecified malignant neoplasm of the tongue
C05.0- Malignant neoplasm of the hard palate (aids in swallowing while gripping the tongue and separating the oral and nasal cavities).
C05.1- Malignant neoplasm of the soft palate (prevents nasal reflux during swallowing by closing the nasopharynx).
C05.2- Malignant neoplasm of the uvula (prevents food and liquid from going up the nose while swallowing).
C06.9- Unspecified malignant neoplasm of the mouth
C15.9- Unspecified malignant neoplasm of the esophagus
C32.0- Malignant neoplasm of the glottis
C32.3- Malignant neoplasm of the laryngeal cartilage
C32.9- Unspecified malignant neoplasm of the larynx
C49.A1- Gastrointestinal stromal tumor of the esophagus
The neuromuscular conditions associated with Dysphagia are coded as follows:
G12.21- Amyotrophic lateral sclerosis (causes tongue atrophy and dysfunction in soft palate and larynx function, leading to Dysphagia).
G14- Postpolio syndrome (causes oral motor weakness and oral pharyngeal paralysis leading to Dysphagia).
G20- Parkinson’s disease ( affects the facial, neck, and throat muscles, leading to difficulty swallowing).
G35- Multiple sclerosis (poor coordination among mouth and throat muscles makes swallowing difficult).
G70.80- Lambert-Eaten Syndrome (weakening of muscles leads to poor functioning), Unspecified
G70.81- Lambert-Eaten Syndrome in diseases classified elsewhere
G71.00- Muscular dystrophy, unspecified
G71.01- Duchene or Becker muscular dystrophy (progressive weakness of oropharyngeal muscles leading to Dysphagia)
G71.02- Facioscapulohumeral muscular dystrophy
G82.50- Unspecified Quadriplegia
Some general conditions associated with Dysphagia are coded as follows:
R63.30- Unspecified feeding difficulties
R63.31- Pediatric feeding disorder, acute
R63.32- Pediatric feeding disorder, chronic
R63.39- Other feeding difficulties
Causes of Dysphagia
Dysphagia occurs due to different reasons. Any condition that affects or weakens muscles and nerves involved in swallowing or narrows the food pipe is a cause of Dysphagia. The following situations can lead to Dysphagia:
Presence of any foreign body
Any foreign body can block the passage of food and make swallowing difficult. Older adults with dentures face this situation the most.
Achalasia is the dysfunction of the Lower Esophageal Sphincter (LES) muscle. LES becomes hypersensitive, and its relaxation becomes impaired. Impaired relaxation causes the regurgitation of food back up into the throat.
The involuntary muscles in the lower esophagus undergo poor contractions making swallowing difficult.
Esophageal Stricture: Narrowing of the esophagus makes it difficult for the bolus to pass through the esophagus. The stricture can result from a tumor, scar, or damaged epithelium due to GERD.
Esophageal tumors narrow the esophagus and make swallowing difficult.
Gastroesophageal Reflux Disease (GERD): GERD causes the reflux of acidic contents back into the throat or mouth. It damages the epithelial lining of the esophagus and causes Dysphagia.
Scleroderma leads to the hardening of tissues. It leads to poor relaxation of the lower esophageal sphincter muscle and, as a result, impaired swallowing.
People with conditions like Multiple Sclerosis and Parkinsonism often suffer from Dysphagia due to the failure of esophageal muscles to contract and relax properly. The same goes for conditions that damage the brain or spinal cord, such as traumatic brain injury (TBI), spinal cord injury (SCI), stroke, etc.
Also termed Pharyngoesophageal diverticulum, this condition causes the formation of a small pouch in the throat above the esophagus. It leads to Dysphagia, coughing, and bad breath.
Dysphagia can lead to a decrease in the uptake of food or liquid, causing malnutrition, dehydration, and as a result, weight loss. The inability to swallow correctly can lead to aspiration, choking, and aspirational pneumonia.
Important Coding Tips for ICD-10 Dysphagia:
- When the type or description of Dysphagia is not mentioned in the patient’s medical record, always use unspecified Code 10 with the respective Diagnostic Cpt code.
- If Dysphagia is associated with or due to brain injury, then use Code first, if applicable, Dysphagia following cerebrovascular disease (I69. with final characters -91)
- If the document states “psychogenic dysphagia” and “Difficulty in swallowing,” then do not code for psychogenic Dysphagia (F45.8) because these two conditions can not be billed together.
Audrey Howard; Coding for Dysphagia; For The Record; March 14, 2011; Vol. 23 No. 5 P. 27.
Dysphagia ICD-10; ICD 10 CODES SPEECH THERAPY; THERAPlatform.
Article – Billing and Coding: Swallowing Studies for Dysphagia (A56621); 2022.
Maurizio Paciaroni Giovanni Mazzotta Francesco Corea Valeria Caso Michele Venti Paoto Milia Giorgio Silvestrelli Francesco Palmerini Luciila Parnetti Virgilio Gallai; Dysphagia following Stroke; European Neurology; 2004.
DOI: 10.1 159/000077663
ICD 10 Version :2019; World Health Organisation
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