LCD Reference Article Billing and Coding Article

Billing and Coding: Outpatient Speech Language Pathology

A56868

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Draft Articles are works in progress and not necessarily a reflection of the current billing and coding practices. Revisions to codes are carefully and thoroughly reviewed and are not intended to change the original intent of the LCD.

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Source Article ID
N/A
Article ID
A56868
Original ICD-9 Article ID
Not Applicable
Article Title
Billing and Coding: Outpatient Speech Language Pathology
Article Type
Billing and Coding
Original Effective Date
08/15/2019
Revision Effective Date
10/01/2024
Revision Ending Date
N/A
Retirement Date
N/A

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CMS National Coverage Policy

Title XVIII of the Social Security Act, §1833(e) prohibits Medicare payment for any claim which lacks the necessary information to process the claim.

CMS Internet-Only Manual, Pub. 100-02, Medicare Benefit Policy Manual, Chapter 12, §20.1 Required Services, §30 Rules for Provision of Services, and §30.1 Rules for Payment of CORF Services

CMS Internet-Only Manual, Pub. 100-02, Medicare Benefit Policy Manual, Chapter 15, §220 Coverage of Outpatient Rehabilitation Therapy Services (Physical Therapy, Occupational Therapy, and Speech-Language Pathology Services) Under Medical Insurance, §220.1 Conditions of Coverage and Payment for Outpatient Physical Therapy, Occupational Therapy, or Speech-Language Pathology Services, §220.4 Functional Reporting

CMS Internet-Only Manual, Pub. 100-04, Medicare Claims Processing Manual, Chapter 5, §10 Part B Outpatient Rehabilitation and Comprehensive Outpatient Rehabilitation Facility (CORF) Services-General, §10.5 Notification for Beneficiaries Exceeding Financial Limitations, §10.6 Functional Reporting, §10.7 Multiple Procedure Payment Reductions for Outpatient Rehabilitation Services, §20 HCPCS Coding Requirement, §20.2 Reporting of Service Units With HCPCS, and §40.2 Applicable Types of Bill, §40.3 Applicable Revenue Codes, §40.4 Edit Requirements for Revenue Codes, and §40.5 Line Item Date of Service Reporting

CMS Internet-Only Manual, Pub. 100-04, Medicare Claims Processing Manual, Chapter 12, §30.3 Audiology Services

CMS Internet-Only Manual, Pub. 100-04, Medicare Claims Processing Manual, Chapter 23, §10 Reporting ICD Diagnosis and Procedure Codes

Article Guidance

Article Text

The information in this article contains billing, coding or other guidelines that complement the Local Coverage Determination (LCD) for Outpatient Speech Language Pathology L34429.

Evaluation/Re-evaluation

Note: Current Procedural Terminology (CPT®) does not define a re-evaluation code for Speech Language Pathology: use the evaluation code.

1. Treatment of speech, language, voice, communication, and/or auditory processing disorder (CPT® code 92507); individual

  • Regarding speech-generating devices (SGDs), use CPT® code 92607 and 92608 for selection and prescription; use CPT® code 92609 for programming and modification.

2. Treatment of speech, language, voice, communication, and/or auditory processing disorder; group, 2 or more individuals (CPT® code 92508)

  • Note: Regardless of the therapy being performed, if the patient is not receiving direct 1-on-1 contact but is being supervised by the therapist, the group therapy code should be used.

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ICD-10-CM Codes that Support Medical Necessity

Group 1

(583 Codes)
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Group 1 Codes
Code Description
A52.17 General paresis
A81.00 Creutzfeldt-Jakob disease, unspecified
A81.01 Variant Creutzfeldt-Jakob disease
A81.09 Other Creutzfeldt-Jakob disease
E75.00 GM2 gangliosidosis, unspecified
E75.01 Sandhoff disease
E75.02 Tay-Sachs disease
E75.09 Other GM2 gangliosidosis
E75.11 Mucolipidosis IV
E75.19 Other gangliosidosis
E75.27 Pelizaeus-Merzbacher disease
E75.28 Canavan disease
E75.4 Neuronal ceroid lipofuscinosis
E83.01 Wilson's disease
E83.09 Other disorders of copper metabolism
F01.518 Vascular dementia, unspecified severity, with other behavioral disturbance
F01.A18 Vascular dementia, mild, with other behavioral disturbance
F01.B18 Vascular dementia, moderate, with other behavioral disturbance
F01.C18 Vascular dementia, severe, with other behavioral disturbance
F02.818 Dementia in other diseases classified elsewhere, unspecified severity, with other behavioral disturbance
F02.A18 Dementia in other diseases classified elsewhere, mild, with other behavioral disturbance
F02.B18 Dementia in other diseases classified elsewhere, moderate, with other behavioral disturbance
F02.C18 Dementia in other diseases classified elsewhere, severe, with other behavioral disturbance
F07.81 Postconcussional syndrome
F80.0 Phonological disorder
F80.1 Expressive language disorder
F80.2 Mixed receptive-expressive language disorder
F80.4 Speech and language development delay due to hearing loss
F80.81 Childhood onset fluency disorder
F80.82 Social pragmatic communication disorder
F80.89 Other developmental disorders of speech and language
F80.9 Developmental disorder of speech and language, unspecified
F81.0 Specific reading disorder
F81.81 Disorder of written expression
F82 Specific developmental disorder of motor function
F88 Other disorders of psychological development
F95.2 Tourette's disorder
F98.29 Other feeding disorders of infancy and early childhood
F98.5 Adult onset fluency disorder
G10 Huntington's disease
G24.09 Other drug induced dystonia
G24.2 Idiopathic nonfamilial dystonia
G24.4 Idiopathic orofacial dystonia
G24.8 Other dystonia
G30.0 Alzheimer's disease with early onset
G30.1 Alzheimer's disease with late onset
G30.8 Other Alzheimer's disease
G31.01 Pick's disease
G31.09 Other frontotemporal neurocognitive disorder
G31.80 Leukodystrophy, unspecified
G31.83 Neurocognitive disorder with Lewy bodies
G31.85 Corticobasal degeneration
G35 Multiple sclerosis
G36.0 Neuromyelitis optica [Devic]
G36.1 Acute and subacute hemorrhagic leukoencephalitis [Hurst]
G36.8 Other specified acute disseminated demyelination
G36.9 Acute disseminated demyelination, unspecified
G37.0 Diffuse sclerosis of central nervous system
G37.1 Central demyelination of corpus callosum
G37.2 Central pontine myelinolysis
G37.3 Acute transverse myelitis in demyelinating disease of central nervous system
G37.4 Subacute necrotizing myelitis of central nervous system
G37.5 Concentric sclerosis [Balo] of central nervous system
G37.89 Other specified demyelinating diseases of central nervous system
G37.9 Demyelinating disease of central nervous system, unspecified
G40.001 Localization-related (focal) (partial) idiopathic epilepsy and epileptic syndromes with seizures of localized onset, not intractable, with status epilepticus
G40.009 Localization-related (focal) (partial) idiopathic epilepsy and epileptic syndromes with seizures of localized onset, not intractable, without status epilepticus
G40.011 Localization-related (focal) (partial) idiopathic epilepsy and epileptic syndromes with seizures of localized onset, intractable, with status epilepticus
G40.019 Localization-related (focal) (partial) idiopathic epilepsy and epileptic syndromes with seizures of localized onset, intractable, without status epilepticus
G40.101 Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with simple partial seizures, not intractable, with status epilepticus
G40.109 Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with simple partial seizures, not intractable, without status epilepticus
G40.111 Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with simple partial seizures, intractable, with status epilepticus
G40.119 Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with simple partial seizures, intractable, without status epilepticus
G40.201 Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with complex partial seizures, not intractable, with status epilepticus
G40.209 Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with complex partial seizures, not intractable, without status epilepticus
G40.211 Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with complex partial seizures, intractable, with status epilepticus
G40.219 Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with complex partial seizures, intractable, without status epilepticus
G40.301 Generalized idiopathic epilepsy and epileptic syndromes, not intractable, with status epilepticus
G40.309 Generalized idiopathic epilepsy and epileptic syndromes, not intractable, without status epilepticus
G40.311 Generalized idiopathic epilepsy and epileptic syndromes, intractable, with status epilepticus
G40.319 Generalized idiopathic epilepsy and epileptic syndromes, intractable, without status epilepticus
G40.A01 Absence epileptic syndrome, not intractable, with status epilepticus
G40.A09 Absence epileptic syndrome, not intractable, without status epilepticus
G40.A11 Absence epileptic syndrome, intractable, with status epilepticus
G40.A19 Absence epileptic syndrome, intractable, without status epilepticus
G40.B01 Juvenile myoclonic epilepsy, not intractable, with status epilepticus
G40.B09 Juvenile myoclonic epilepsy, not intractable, without status epilepticus
G40.B11 Juvenile myoclonic epilepsy, intractable, with status epilepticus
G40.B19 Juvenile myoclonic epilepsy, intractable, without status epilepticus
G40.401 Other generalized epilepsy and epileptic syndromes, not intractable, with status epilepticus
G40.409 Other generalized epilepsy and epileptic syndromes, not intractable, without status epilepticus
G40.411 Other generalized epilepsy and epileptic syndromes, intractable, with status epilepticus
G40.419 Other generalized epilepsy and epileptic syndromes, intractable, without status epilepticus
G40.42 Cyclin-Dependent Kinase-Like 5 Deficiency Disorder
G40.501 Epileptic seizures related to external causes, not intractable, with status epilepticus
G40.509 Epileptic seizures related to external causes, not intractable, without status epilepticus
G40.801 Other epilepsy, not intractable, with status epilepticus
G40.802 Other epilepsy, not intractable, without status epilepticus
G40.803 Other epilepsy, intractable, with status epilepticus
G40.804 Other epilepsy, intractable, without status epilepticus
G40.811 Lennox-Gastaut syndrome, not intractable, with status epilepticus
G40.812 Lennox-Gastaut syndrome, not intractable, without status epilepticus
G40.813 Lennox-Gastaut syndrome, intractable, with status epilepticus
G40.814 Lennox-Gastaut syndrome, intractable, without status epilepticus
G40.821 Epileptic spasms, not intractable, with status epilepticus
G40.822 Epileptic spasms, not intractable, without status epilepticus
G40.823 Epileptic spasms, intractable, with status epilepticus
G40.824 Epileptic spasms, intractable, without status epilepticus
G40.833 Dravet syndrome, intractable, with status epilepticus
G40.834 Dravet syndrome, intractable, without status epilepticus
G40.841 KCNQ2-related epilepsy, not intractable, with status epilepticus
G40.842 KCNQ2-related epilepsy, not intractable, without status epilepticus
G40.843 KCNQ2-related epilepsy, intractable, with status epilepticus
G40.844 KCNQ2-related epilepsy, intractable, without status epilepticus
G40.89 Other seizures
G40.901 Epilepsy, unspecified, not intractable, with status epilepticus
G40.909 Epilepsy, unspecified, not intractable, without status epilepticus
G40.911 Epilepsy, unspecified, intractable, with status epilepticus
G40.919 Epilepsy, unspecified, intractable, without status epilepticus
G51.0 Bell's palsy
G51.1 Geniculate ganglionitis
G51.2 Melkersson's syndrome
G51.4 Facial myokymia
G51.8 Other disorders of facial nerve
G51.9 Disorder of facial nerve, unspecified
G52.1 Disorders of glossopharyngeal nerve
G70.00 Myasthenia gravis without (acute) exacerbation
G70.01 Myasthenia gravis with (acute) exacerbation
G70.1 Toxic myoneural disorders
G70.2 Congenital and developmental myasthenia
G70.80 Lambert-Eaton syndrome, unspecified
G70.81 Lambert-Eaton syndrome in disease classified elsewhere
G70.89 Other specified myoneural disorders
G70.9 Myoneural disorder, unspecified
G71.11 Myotonic muscular dystrophy
G71.12 Myotonia congenita
G71.13 Myotonic chondrodystrophy
G71.14 Drug induced myotonia
G71.19 Other specified myotonic disorders
G71.20 Congenital myopathy, unspecified
G71.21 Nemaline myopathy
G71.220 X-linked myotubular myopathy
G71.228 Other centronuclear myopathy
G71.29 Other congenital myopathy
G72.0 Drug-induced myopathy
G72.1 Alcoholic myopathy
G72.2 Myopathy due to other toxic agents
G72.3 Periodic paralysis
G73.1 Lambert-Eaton syndrome in neoplastic disease
G80.0 Spastic quadriplegic cerebral palsy
G80.1 Spastic diplegic cerebral palsy
G80.2 Spastic hemiplegic cerebral palsy
G80.3 Athetoid cerebral palsy
G80.4 Ataxic cerebral palsy
G80.8 Other cerebral palsy
G80.9 Cerebral palsy, unspecified
G81.01 Flaccid hemiplegia affecting right dominant side
G81.02 Flaccid hemiplegia affecting left dominant side
G81.03 Flaccid hemiplegia affecting right nondominant side
G81.04 Flaccid hemiplegia affecting left nondominant side
G81.11 Spastic hemiplegia affecting right dominant side
G81.12 Spastic hemiplegia affecting left dominant side
G81.13 Spastic hemiplegia affecting right nondominant side
G81.14 Spastic hemiplegia affecting left nondominant side
G81.91 Hemiplegia, unspecified affecting right dominant side
G81.92 Hemiplegia, unspecified affecting left dominant side
G81.93 Hemiplegia, unspecified affecting right nondominant side
G81.94 Hemiplegia, unspecified affecting left nondominant side
G83.5 Locked-in state
G83.81 Brown-Sequard syndrome
G83.82 Anterior cord syndrome
G83.83 Posterior cord syndrome
G83.84 Todd's paralysis (postepileptic)
G83.89 Other specified paralytic syndromes
G83.9 Paralytic syndrome, unspecified
H90.0 Conductive hearing loss, bilateral
H90.11 Conductive hearing loss, unilateral, right ear, with unrestricted hearing on the contralateral side
H90.12 Conductive hearing loss, unilateral, left ear, with unrestricted hearing on the contralateral side
H90.3 Sensorineural hearing loss, bilateral
H90.41 Sensorineural hearing loss, unilateral, right ear, with unrestricted hearing on the contralateral side
H90.42 Sensorineural hearing loss, unilateral, left ear, with unrestricted hearing on the contralateral side
H90.6 Mixed conductive and sensorineural hearing loss, bilateral
H90.71 Mixed conductive and sensorineural hearing loss, unilateral, right ear, with unrestricted hearing on the contralateral side
H90.72 Mixed conductive and sensorineural hearing loss, unilateral, left ear, with unrestricted hearing on the contralateral side
H90.A11 Conductive hearing loss, unilateral, right ear with restricted hearing on the contralateral side
H90.A12 Conductive hearing loss, unilateral, left ear with restricted hearing on the contralateral side
H90.A21 Sensorineural hearing loss, unilateral, right ear, with restricted hearing on the contralateral side
H90.A22 Sensorineural hearing loss, unilateral, left ear, with restricted hearing on the contralateral side
H90.A31 Mixed conductive and sensorineural hearing loss, unilateral, right ear with restricted hearing on the contralateral side
H90.A32 Mixed conductive and sensorineural hearing loss, unilateral, left ear with restricted hearing on the contralateral side
H91.3 Deaf nonspeaking, not elsewhere classified
H93.221 Diplacusis, right ear
H93.222 Diplacusis, left ear
H93.223 Diplacusis, bilateral
H93.241 Temporary auditory threshold shift, right ear
H93.242 Temporary auditory threshold shift, left ear
H93.243 Temporary auditory threshold shift, bilateral
H93.25 Central auditory processing disorder
H93.291 Other abnormal auditory perceptions, right ear
H93.292 Other abnormal auditory perceptions, left ear
H93.293 Other abnormal auditory perceptions, bilateral
I69.010 Attention and concentration deficit following nontraumatic subarachnoid hemorrhage
I69.012 Visuospatial deficit and spatial neglect following nontraumatic subarachnoid hemorrhage
I69.013 Psychomotor deficit following nontraumatic subarachnoid hemorrhage
I69.014 Frontal lobe and executive function deficit following nontraumatic subarachnoid hemorrhage
I69.015 Cognitive social or emotional deficit following nontraumatic subarachnoid hemorrhage
I69.018 Other symptoms and signs involving cognitive functions following nontraumatic subarachnoid hemorrhage
I69.019 Unspecified symptoms and signs involving cognitive functions following nontraumatic subarachnoid hemorrhage
I69.020 Aphasia following nontraumatic subarachnoid hemorrhage
I69.021 Dysphasia following nontraumatic subarachnoid hemorrhage
I69.022 Dysarthria following nontraumatic subarachnoid hemorrhage
I69.023 Fluency disorder following nontraumatic subarachnoid hemorrhage
I69.028 Other speech and language deficits following nontraumatic subarachnoid hemorrhage
I69.090 Apraxia following nontraumatic subarachnoid hemorrhage
I69.091 Dysphagia following nontraumatic subarachnoid hemorrhage
I69.092 Facial weakness following nontraumatic subarachnoid hemorrhage
I69.110 Attention and concentration deficit following nontraumatic intracerebral hemorrhage
I69.112 Visuospatial deficit and spatial neglect following nontraumatic intracerebral hemorrhage
I69.114 Frontal lobe and executive function deficit following nontraumatic intracerebral hemorrhage
I69.115 Cognitive social or emotional deficit following nontraumatic intracerebral hemorrhage
I69.118 Other symptoms and signs involving cognitive functions following nontraumatic intracerebral hemorrhage
I69.120 Aphasia following nontraumatic intracerebral hemorrhage
I69.121 Dysphasia following nontraumatic intracerebral hemorrhage
I69.122 Dysarthria following nontraumatic intracerebral hemorrhage
I69.123 Fluency disorder following nontraumatic intracerebral hemorrhage
I69.128 Other speech and language deficits following nontraumatic intracerebral hemorrhage
I69.190 Apraxia following nontraumatic intracerebral hemorrhage
I69.191 Dysphagia following nontraumatic intracerebral hemorrhage
I69.192 Facial weakness following nontraumatic intracerebral hemorrhage
I69.210 Attention and concentration deficit following other nontraumatic intracranial hemorrhage
I69.212 Visuospatial deficit and spatial neglect following other nontraumatic intracranial hemorrhage
I69.214 Frontal lobe and executive function deficit following other nontraumatic intracranial hemorrhage
I69.215 Cognitive social or emotional deficit following other nontraumatic intracranial hemorrhage
I69.220 Aphasia following other nontraumatic intracranial hemorrhage
I69.221 Dysphasia following other nontraumatic intracranial hemorrhage
I69.222 Dysarthria following other nontraumatic intracranial hemorrhage
I69.223 Fluency disorder following other nontraumatic intracranial hemorrhage
I69.228 Other speech and language deficits following other nontraumatic intracranial hemorrhage
I69.290 Apraxia following other nontraumatic intracranial hemorrhage
I69.291 Dysphagia following other nontraumatic intracranial hemorrhage
I69.292 Facial weakness following other nontraumatic intracranial hemorrhage
I69.310 Attention and concentration deficit following cerebral infarction
I69.312 Visuospatial deficit and spatial neglect following cerebral infarction
I69.313 Psychomotor deficit following cerebral infarction
I69.314 Frontal lobe and executive function deficit following cerebral infarction
I69.315 Cognitive social or emotional deficit following cerebral infarction
I69.320 Aphasia following cerebral infarction
I69.321 Dysphasia following cerebral infarction
I69.322 Dysarthria following cerebral infarction
I69.323 Fluency disorder following cerebral infarction
I69.328 Other speech and language deficits following cerebral infarction
I69.390 Apraxia following cerebral infarction
I69.391 Dysphagia following cerebral infarction
I69.392 Facial weakness following cerebral infarction
I69.810 Attention and concentration deficit following other cerebrovascular disease
I69.812 Visuospatial deficit and spatial neglect following other cerebrovascular disease
I69.813 Psychomotor deficit following other cerebrovascular disease
I69.814 Frontal lobe and executive function deficit following other cerebrovascular disease
I69.815 Cognitive social or emotional deficit following other cerebrovascular disease
I69.820 Aphasia following other cerebrovascular disease
I69.821 Dysphasia following other cerebrovascular disease
I69.822 Dysarthria following other cerebrovascular disease
I69.823 Fluency disorder following other cerebrovascular disease
I69.828 Other speech and language deficits following other cerebrovascular disease
I69.890 Apraxia following other cerebrovascular disease
I69.891 Dysphagia following other cerebrovascular disease
I69.892 Facial weakness following other cerebrovascular disease
I69.910 Attention and concentration deficit following unspecified cerebrovascular disease
I69.912 Visuospatial deficit and spatial neglect following unspecified cerebrovascular disease
I69.913 Psychomotor deficit following unspecified cerebrovascular disease
I69.914 Frontal lobe and executive function deficit following unspecified cerebrovascular disease
I69.915 Cognitive social or emotional deficit following unspecified cerebrovascular disease
I69.920 Aphasia following unspecified cerebrovascular disease
I69.921 Dysphasia following unspecified cerebrovascular disease
I69.922 Dysarthria following unspecified cerebrovascular disease
I69.923 Fluency disorder following unspecified cerebrovascular disease
I69.928 Other speech and language deficits following unspecified cerebrovascular disease
I69.990 Apraxia following unspecified cerebrovascular disease
I69.991 Dysphagia following unspecified cerebrovascular disease
I69.992 Facial weakness following unspecified cerebrovascular disease
J37.0 Chronic laryngitis
J37.1 Chronic laryngotracheitis
J38.01 Paralysis of vocal cords and larynx, unilateral
J38.02 Paralysis of vocal cords and larynx, bilateral
J38.1 Polyp of vocal cord and larynx
J38.2 Nodules of vocal cords
J38.3 Other diseases of vocal cords
J38.4 Edema of larynx
J38.5 Laryngeal spasm
J38.6 Stenosis of larynx
J38.7 Other diseases of larynx
J39.0 Retropharyngeal and parapharyngeal abscess
J39.1 Other abscess of pharynx
J39.2 Other diseases of pharynx
K14.8 Other diseases of tongue
M26.20 Unspecified anomaly of dental arch relationship
M26.211 Malocclusion, Angle's class I
M26.212 Malocclusion, Angle's class II
M26.213 Malocclusion, Angle's class III
M26.220 Open anterior occlusal relationship
M26.221 Open posterior occlusal relationship
M26.23 Excessive horizontal overlap
M26.24 Reverse articulation
M26.25 Anomalies of interarch distance
M26.29 Other anomalies of dental arch relationship
M26.50 Dentofacial functional abnormalities, unspecified
M30.0 Polyarteritis nodosa
M30.2 Juvenile polyarteritis
M30.8 Other conditions related to polyarteritis nodosa
M31.7 Microscopic polyangiitis
Q31.1 Congenital subglottic stenosis
Q31.2 Laryngeal hypoplasia
Q31.3 Laryngocele
Q31.5 Congenital laryngomalacia
Q31.8 Other congenital malformations of larynx
Q31.9 Congenital malformation of larynx, unspecified
Q32.0 Congenital tracheomalacia
Q32.1 Other congenital malformations of trachea
Q32.2 Congenital bronchomalacia
Q32.3 Congenital stenosis of bronchus
Q32.4 Other congenital malformations of bronchus
Q35.1 Cleft hard palate
Q35.3 Cleft soft palate
Q35.5 Cleft hard palate with cleft soft palate
Q35.7 Cleft uvula
Q36.0 Cleft lip, bilateral
Q36.1 Cleft lip, median
Q36.9 Cleft lip, unilateral
Q37.0 Cleft hard palate with bilateral cleft lip
Q37.1 Cleft hard palate with unilateral cleft lip
Q37.2 Cleft soft palate with bilateral cleft lip
Q37.3 Cleft soft palate with unilateral cleft lip
Q37.4 Cleft hard and soft palate with bilateral cleft lip
Q37.5 Cleft hard and soft palate with unilateral cleft lip
Q38.1 Ankyloglossia
Q38.2 Macroglossia
Q38.3 Other congenital malformations of tongue
R05.8 Other specified cough
R06.89 Other abnormalities of breathing
R13.0 Aphagia
R13.10 Dysphagia, unspecified
R13.11 Dysphagia, oral phase
R13.12 Dysphagia, oropharyngeal phase
R13.13 Dysphagia, pharyngeal phase
R13.14 Dysphagia, pharyngoesophageal phase
R13.19 Other dysphagia
R41.4 Neurologic neglect syndrome
R41.841 Cognitive communication deficit
R41.85 Anosognosia
R47.01 Aphasia
R47.02 Dysphasia
R47.1 Dysarthria and anarthria
R47.81 Slurred speech
R47.82 Fluency disorder in conditions classified elsewhere
R47.89 Other speech disturbances
R48.0 Dyslexia and alexia
R48.1 Agnosia
R48.2 Apraxia
R48.8 Other symbolic dysfunctions
R49.0 Dysphonia
R49.1 Aphonia
R49.8 Other voice and resonance disorders
R62.0 Delayed milestone in childhood
R63.39 Other feeding difficulties
S01.522S Laceration with foreign body of oral cavity, sequela
S01.531S Puncture wound without foreign body of lip, sequela
S01.532S Puncture wound without foreign body of oral cavity, sequela
S01.541S Puncture wound with foreign body of lip, sequela
S01.542S Puncture wound with foreign body of oral cavity, sequela
S06.0X0S Concussion without loss of consciousness, sequela
S06.0X1S Concussion with loss of consciousness of 30 minutes or less, sequela
S06.0X9S Concussion with loss of consciousness of unspecified duration, sequela
S06.1X0S Traumatic cerebral edema without loss of consciousness, sequela
S06.1X1S Traumatic cerebral edema with loss of consciousness of 30 minutes or less, sequela
S06.1X2S Traumatic cerebral edema with loss of consciousness of 31 minutes to 59 minutes, sequela
S06.1X3S Traumatic cerebral edema with loss of consciousness of 1 hour to 5 hours 59 minutes, sequela
S06.1X4S Traumatic cerebral edema with loss of consciousness of 6 hours to 24 hours, sequela
S06.1X5S Traumatic cerebral edema with loss of consciousness greater than 24 hours with return to pre-existing conscious level, sequela
S06.1XAA Traumatic cerebral edema with loss of consciousness status unknown, initial encounter
S06.1XAD Traumatic cerebral edema with loss of consciousness status unknown, subsequent encounter
S06.1XAS Traumatic cerebral edema with loss of consciousness status unknown, sequela
S06.1X9S Traumatic cerebral edema with loss of consciousness of unspecified duration, sequela
S06.2X0S Diffuse traumatic brain injury without loss of consciousness, sequela
S06.2X1S Diffuse traumatic brain injury with loss of consciousness of 30 minutes or less, sequela
S06.2X2S Diffuse traumatic brain injury with loss of consciousness of 31 minutes to 59 minutes, sequela
S06.2X3S Diffuse traumatic brain injury with loss of consciousness of 1 hour to 5 hours 59 minutes, sequela
S06.2X4S Diffuse traumatic brain injury with loss of consciousness of 6 hours to 24 hours, sequela
S06.2X5S Diffuse traumatic brain injury with loss of consciousness greater than 24 hours with return to pre-existing conscious levels, sequela
S06.2XAA Diffuse traumatic brain injury with loss of consciousness status unknown, initial encounter
S06.2XAD Diffuse traumatic brain injury with loss of consciousness status unknown, subsequent encounter
S06.2XAS Diffuse traumatic brain injury with loss of consciousness status unknown, sequela
S06.2X9S Diffuse traumatic brain injury with loss of consciousness of unspecified duration, sequela
S06.300S Unspecified focal traumatic brain injury without loss of consciousness, sequela
S06.301S Unspecified focal traumatic brain injury with loss of consciousness of 30 minutes or less, sequela
S06.302S Unspecified focal traumatic brain injury with loss of consciousness of 31 minutes to 59 minutes, sequela
S06.303S Unspecified focal traumatic brain injury with loss of consciousness of 1 hour to 5 hours 59 minutes, sequela
S06.304S Unspecified focal traumatic brain injury with loss of consciousness of 6 hours to 24 hours, sequela
S06.305S Unspecified focal traumatic brain injury with loss of consciousness greater than 24 hours with return to pre-existing conscious level, sequela
S06.309S Unspecified focal traumatic brain injury with loss of consciousness of unspecified duration, sequela
S06.310S Contusion and laceration of right cerebrum without loss of consciousness, sequela
S06.311S Contusion and laceration of right cerebrum with loss of consciousness of 30 minutes or less, sequela
S06.312S Contusion and laceration of right cerebrum with loss of consciousness of 31 minutes to 59 minutes, sequela
S06.313S Contusion and laceration of right cerebrum with loss of consciousness of 1 hour to 5 hours 59 minutes, sequela
S06.314S Contusion and laceration of right cerebrum with loss of consciousness of 6 hours to 24 hours, sequela
S06.315S Contusion and laceration of right cerebrum with loss of consciousness greater than 24 hours with return to pre-existing conscious level, sequela
S06.31AA Contusion and laceration of right cerebrum with loss of consciousness status unknown, initial encounter
S06.31AD Contusion and laceration of right cerebrum with loss of consciousness status unknown, subsequent encounter
S06.31AS Contusion and laceration of right cerebrum with loss of consciousness status unknown, sequela
S06.319S Contusion and laceration of right cerebrum with loss of consciousness of unspecified duration, sequela
S06.320S Contusion and laceration of left cerebrum without loss of consciousness, sequela
S06.321S Contusion and laceration of left cerebrum with loss of consciousness of 30 minutes or less, sequela
S06.322S Contusion and laceration of left cerebrum with loss of consciousness of 31 minutes to 59 minutes, sequela
S06.323S Contusion and laceration of left cerebrum with loss of consciousness of 1 hour to 5 hours 59 minutes, sequela
S06.324S Contusion and laceration of left cerebrum with loss of consciousness of 6 hours to 24 hours, sequela
S06.325S Contusion and laceration of left cerebrum with loss of consciousness greater than 24 hours with return to pre-existing conscious level, sequela
S06.32AA Contusion and laceration of left cerebrum with loss of consciousness status unknown, initial encounter
S06.32AD Contusion and laceration of left cerebrum with loss of consciousness status unknown, subsequent encounter
S06.32AS Contusion and laceration of left cerebrum with loss of consciousness status unknown, sequela
S06.329S Contusion and laceration of left cerebrum with loss of consciousness of unspecified duration, sequela
S06.33AA Contusion and laceration of cerebrum, unspecified, with loss of consciousness status unknown, initial encounter
S06.33AD Contusion and laceration of cerebrum, unspecified, with loss of consciousness status unknown, subsequent encounter
S06.33AS Contusion and laceration of cerebrum, unspecified, with loss of consciousness status unknown, sequela
S06.340S Traumatic hemorrhage of right cerebrum without loss of consciousness, sequela
S06.341S Traumatic hemorrhage of right cerebrum with loss of consciousness of 30 minutes or less, sequela
S06.342S Traumatic hemorrhage of right cerebrum with loss of consciousness of 31 minutes to 59 minutes, sequela
S06.343S Traumatic hemorrhage of right cerebrum with loss of consciousness of 1 hours to 5 hours 59 minutes, sequela
S06.344S Traumatic hemorrhage of right cerebrum with loss of consciousness of 6 hours to 24 hours, sequela
S06.345S Traumatic hemorrhage of right cerebrum with loss of consciousness greater than 24 hours with return to pre-existing conscious level, sequela
S06.346S Traumatic hemorrhage of right cerebrum with loss of consciousness greater than 24 hours without return to pre-existing conscious level with patient surviving, sequela
S06.34AA Traumatic hemorrhage of right cerebrum with loss of consciousness status unknown, initial encounter
S06.34AD Traumatic hemorrhage of right cerebrum with loss of consciousness status unknown, subsequent encounter
S06.34AS Traumatic hemorrhage of right cerebrum with loss of consciousness status unknown, sequela
S06.349S Traumatic hemorrhage of right cerebrum with loss of consciousness of unspecified duration, sequela
S06.350S Traumatic hemorrhage of left cerebrum without loss of consciousness, sequela
S06.351S Traumatic hemorrhage of left cerebrum with loss of consciousness of 30 minutes or less, sequela
S06.352S Traumatic hemorrhage of left cerebrum with loss of consciousness of 31 minutes to 59 minutes, sequela
S06.353S Traumatic hemorrhage of left cerebrum with loss of consciousness of 1 hours to 5 hours 59 minutes, sequela
S06.354S Traumatic hemorrhage of left cerebrum with loss of consciousness of 6 hours to 24 hours, sequela
S06.355S Traumatic hemorrhage of left cerebrum with loss of consciousness greater than 24 hours with return to pre-existing conscious level, sequela
S06.35AA Traumatic hemorrhage of left cerebrum with loss of consciousness status unknown, initial encounter
S06.35AD Traumatic hemorrhage of left cerebrum with loss of consciousness status unknown, subsequent encounter
S06.35AS Traumatic hemorrhage of left cerebrum with loss of consciousness status unknown, sequela
S06.359S Traumatic hemorrhage of left cerebrum with loss of consciousness of unspecified duration, sequela
S06.36AA Traumatic hemorrhage of cerebrum, unspecified, with loss of consciousness status unknown, initial encounter
S06.36AD Traumatic hemorrhage of cerebrum, unspecified, with loss of consciousness status unknown, subsequent encounter
S06.36AS Traumatic hemorrhage of cerebrum, unspecified, with loss of consciousness status unknown, sequela
S06.370S Contusion, laceration, and hemorrhage of cerebellum without loss of consciousness, sequela
S06.371S Contusion, laceration, and hemorrhage of cerebellum with loss of consciousness of 30 minutes or less, sequela
S06.372S Contusion, laceration, and hemorrhage of cerebellum with loss of consciousness of 31 minutes to 59 minutes, sequela
S06.373S Contusion, laceration, and hemorrhage of cerebellum with loss of consciousness of 1 hour to 5 hours 59 minutes, sequela
S06.374S Contusion, laceration, and hemorrhage of cerebellum with loss of consciousness of 6 hours to 24 hours, sequela
S06.375S Contusion, laceration, and hemorrhage of cerebellum with loss of consciousness greater than 24 hours with return to pre-existing conscious level, sequela
S06.37AA Contusion, laceration, and hemorrhage of cerebellum with loss of consciousness status unknown, initial encounter
S06.37AD Contusion, laceration, and hemorrhage of cerebellum with loss of consciousness status unknown, subsequent encounter
S06.37AS Contusion, laceration, and hemorrhage of cerebellum with loss of consciousness status unknown, sequela
S06.379S Contusion, laceration, and hemorrhage of cerebellum with loss of consciousness of unspecified duration, sequela
S06.380S Contusion, laceration, and hemorrhage of brainstem without loss of consciousness, sequela
S06.381S Contusion, laceration, and hemorrhage of brainstem with loss of consciousness of 30 minutes or less, sequela
S06.382S Contusion, laceration, and hemorrhage of brainstem with loss of consciousness of 31 minutes to 59 minutes, sequela
S06.383S Contusion, laceration, and hemorrhage of brainstem with loss of consciousness of 1 hour to 5 hours 59 minutes, sequela
S06.384S Contusion, laceration, and hemorrhage of brainstem with loss of consciousness of 6 hours to 24 hours, sequela
S06.385S Contusion, laceration, and hemorrhage of brainstem with loss of consciousness greater than 24 hours with return to pre-existing conscious level, sequela
S06.38AA Contusion, laceration, and hemorrhage of brainstem with loss of consciousness status unknown, initial encounter
S06.38AD Contusion, laceration, and hemorrhage of brainstem with loss of consciousness status unknown, subsequent encounter
S06.38AS Contusion, laceration, and hemorrhage of brainstem with loss of consciousness status unknown, sequela
S06.389S Contusion, laceration, and hemorrhage of brainstem with loss of consciousness of unspecified duration, sequela
S06.4X0S Epidural hemorrhage without loss of consciousness, sequela
S06.4X1S Epidural hemorrhage with loss of consciousness of 30 minutes or less, sequela
S06.4X2S Epidural hemorrhage with loss of consciousness of 31 minutes to 59 minutes, sequela
S06.4X3S Epidural hemorrhage with loss of consciousness of 1 hour to 5 hours 59 minutes, sequela
S06.4X4S Epidural hemorrhage with loss of consciousness of 6 hours to 24 hours, sequela
S06.4X5S Epidural hemorrhage with loss of consciousness greater than 24 hours with return to pre-existing conscious level, sequela
S06.4XAA Epidural hemorrhage with loss of consciousness status unknown, initial encounter
S06.4XAD Epidural hemorrhage with loss of consciousness status unknown, subsequent encounter
S06.4XAS Epidural hemorrhage with loss of consciousness status unknown, sequela
S06.4X9S Epidural hemorrhage with loss of consciousness of unspecified duration, sequela
S06.5X0S Traumatic subdural hemorrhage without loss of consciousness, sequela
S06.5X1S Traumatic subdural hemorrhage with loss of consciousness of 30 minutes or less, sequela
S06.5X2S Traumatic subdural hemorrhage with loss of consciousness of 31 minutes to 59 minutes, sequela
S06.5X3S Traumatic subdural hemorrhage with loss of consciousness of 1 hour to 5 hours 59 minutes, sequela
S06.5X4S Traumatic subdural hemorrhage with loss of consciousness of 6 hours to 24 hours, sequela
S06.5X5S Traumatic subdural hemorrhage with loss of consciousness greater than 24 hours with return to pre-existing conscious level, sequela
S06.5XAA Traumatic subdural hemorrhage with loss of consciousness status unknown, initial encounter
S06.5XAD Traumatic subdural hemorrhage with loss of consciousness status unknown, subsequent encounter
S06.5XAS Traumatic subdural hemorrhage with loss of consciousness status unknown, sequela
S06.5X9S Traumatic subdural hemorrhage with loss of consciousness of unspecified duration, sequela
S06.6X0S Traumatic subarachnoid hemorrhage without loss of consciousness, sequela
S06.6X1S Traumatic subarachnoid hemorrhage with loss of consciousness of 30 minutes or less, sequela
S06.6X2S Traumatic subarachnoid hemorrhage with loss of consciousness of 31 minutes to 59 minutes, sequela
S06.6X3S Traumatic subarachnoid hemorrhage with loss of consciousness of 1 hour to 5 hours 59 minutes, sequela
S06.6X4S Traumatic subarachnoid hemorrhage with loss of consciousness of 6 hours to 24 hours, sequela
S06.6X5S Traumatic subarachnoid hemorrhage with loss of consciousness greater than 24 hours with return to pre-existing conscious level, sequela
S06.6XAA Traumatic subarachnoid hemorrhage with loss of consciousness status unknown, initial encounter
S06.6XAD Traumatic subarachnoid hemorrhage with loss of consciousness status unknown, subsequent encounter
S06.6XAS Traumatic subarachnoid hemorrhage with loss of consciousness status unknown, sequela
S06.6X9S Traumatic subarachnoid hemorrhage with loss of consciousness of unspecified duration, sequela
S06.810S Injury of right internal carotid artery, intracranial portion, not elsewhere classified without loss of consciousness, sequela
S06.811S Injury of right internal carotid artery, intracranial portion, not elsewhere classified with loss of consciousness of 30 minutes or less, sequela
S06.812S Injury of right internal carotid artery, intracranial portion, not elsewhere classified with loss of consciousness of 31 minutes to 59 minutes, sequela
S06.813S Injury of right internal carotid artery, intracranial portion, not elsewhere classified with loss of consciousness of 1 hour to 5 hours 59 minutes, sequela
S06.814S Injury of right internal carotid artery, intracranial portion, not elsewhere classified with loss of consciousness of 6 hours to 24 hours, sequela
S06.815S Injury of right internal carotid artery, intracranial portion, not elsewhere classified with loss of consciousness greater than 24 hours with return to pre-existing conscious level, sequela
S06.819S Injury of right internal carotid artery, intracranial portion, not elsewhere classified with loss of consciousness of unspecified duration, sequela
S06.820S Injury of left internal carotid artery, intracranial portion, not elsewhere classified without loss of consciousness, sequela
S06.821S Injury of left internal carotid artery, intracranial portion, not elsewhere classified with loss of consciousness of 30 minutes or less, sequela
S06.822S Injury of left internal carotid artery, intracranial portion, not elsewhere classified with loss of consciousness of 31 minutes to 59 minutes, sequela
S06.823S Injury of left internal carotid artery, intracranial portion, not elsewhere classified with loss of consciousness of 1 hour to 5 hours 59 minutes, sequela
S06.824S Injury of left internal carotid artery, intracranial portion, not elsewhere classified with loss of consciousness of 6 hours to 24 hours, sequela
S06.825S Injury of left internal carotid artery, intracranial portion, not elsewhere classified with loss of consciousness greater than 24 hours with return to pre-existing conscious level, sequela
S06.829S Injury of left internal carotid artery, intracranial portion, not elsewhere classified with loss of consciousness of unspecified duration, sequela
S06.8A0A Primary blast injury of brain, not elsewhere classified without loss of consciousness, initial encounter
S06.8A0D Primary blast injury of brain, not elsewhere classified without loss of consciousness, subsequent encounter
S06.8A0S Primary blast injury of brain, not elsewhere classified without loss of consciousness, sequela
S06.8A1A Primary blast injury of brain, not elsewhere classified with loss of consciousness of 30 minutes or less, initial encounter
S06.8A1D Primary blast injury of brain, not elsewhere classified with loss of consciousness of 30 minutes or less, subsequent encounter
S06.8A1S Primary blast injury of brain, not elsewhere classified with loss of consciousness of 30 minutes or less, sequela
S06.8A2A Primary blast injury of brain, not elsewhere classified with loss of consciousness of 31 minutes to 59 minutes, initial encounter
S06.8A2D Primary blast injury of brain, not elsewhere classified with loss of consciousness of 31 minutes to 59 minutes, subsequent encounter
S06.8A2S Primary blast injury of brain, not elsewhere classified with loss of consciousness of 31 minutes to 59 minutes, sequela
S06.8A3A Primary blast injury of brain, not elsewhere classified with loss of consciousness of 1 hour to 5 hours 59 minutes, initial encounter
S06.8A3D Primary blast injury of brain, not elsewhere classified with loss of consciousness of 1 hour to 5 hours 59 minutes, subsequent encounter
S06.8A3S Primary blast injury of brain, not elsewhere classified with loss of consciousness of 1 hour to 5 hours 59 minutes, sequela
S06.8A4A Primary blast injury of brain, not elsewhere classified with loss of consciousness of 6 hours to 24 hours, initial encounter
S06.8A4D Primary blast injury of brain, not elsewhere classified with loss of consciousness of 6 hours to 24 hours, subsequent encounter
S06.8A4S Primary blast injury of brain, not elsewhere classified with loss of consciousness of 6 hours to 24 hours, sequela
S06.8A5A Primary blast injury of brain, not elsewhere classified with loss of consciousness greater than 24 hours with return to pre-existing conscious level, initial encounter
S06.8A5D Primary blast injury of brain, not elsewhere classified with loss of consciousness greater than 24 hours with return to pre-existing conscious level, subsequent encounter
S06.8A5S Primary blast injury of brain, not elsewhere classified with loss of consciousness greater than 24 hours with return to pre-existing conscious level, sequela
S06.8A6A Primary blast injury of brain, not elsewhere classified with loss of consciousness greater than 24 hours without return to pre-existing conscious level with patient surviving, initial encounter
S06.8A6D Primary blast injury of brain, not elsewhere classified with loss of consciousness greater than 24 hours without return to pre-existing conscious level with patient surviving, subsequent encounter
S06.8A6S Primary blast injury of brain, not elsewhere classified with loss of consciousness greater than 24 hours without return to pre-existing conscious level with patient surviving, sequela
S06.8A7A Primary blast injury of brain, not elsewhere classified with loss of consciousness of any duration with death due to brain injury prior to regaining consciousness, initial encounter
S06.8A8A Primary blast injury of brain, not elsewhere classified with loss of consciousness of any duration with death due to other cause prior to regaining consciousness, initial encounter
S06.8AAA Primary blast injury of brain, not elsewhere classified with loss of consciousness status unknown, initial encounter
S06.8AAD Primary blast injury of brain, not elsewhere classified with loss of consciousness status unknown, subsequent encounter
S06.8AAS Primary blast injury of brain, not elsewhere classified with loss of consciousness status unknown, sequela
S06.8A9A Primary blast injury of brain, not elsewhere classified with loss of consciousness of unspecified duration, initial encounter
S06.8A9D Primary blast injury of brain, not elsewhere classified with loss of consciousness of unspecified duration, subsequent encounter
S06.8A9S Primary blast injury of brain, not elsewhere classified with loss of consciousness of unspecified duration, sequela
S06.890S Other specified intracranial injury without loss of consciousness, sequela
S06.891S Other specified intracranial injury with loss of consciousness of 30 minutes or less, sequela
S06.892S Other specified intracranial injury with loss of consciousness of 31 minutes to 59 minutes, sequela
S06.893S Other specified intracranial injury with loss of consciousness of 1 hour to 5 hours 59 minutes, sequela
S06.894S Other specified intracranial injury with loss of consciousness of 6 hours to 24 hours, sequela
S06.895S Other specified intracranial injury with loss of consciousness greater than 24 hours with return to pre-existing conscious level, sequela
S06.89AA Other specified intracranial injury with loss of consciousness status unknown, initial encounter
S06.89AD Other specified intracranial injury with loss of consciousness status unknown, subsequent encounter
S06.89AS Other specified intracranial injury with loss of consciousness status unknown, sequela
S06.899S Other specified intracranial injury with loss of consciousness of unspecified duration, sequela
S06.9X0S Unspecified intracranial injury without loss of consciousness, sequela
S06.9X1S Unspecified intracranial injury with loss of consciousness of 30 minutes or less, sequela
S06.9X2S Unspecified intracranial injury with loss of consciousness of 31 minutes to 59 minutes, sequela
S06.9X3S Unspecified intracranial injury with loss of consciousness of 1 hour to 5 hours 59 minutes, sequela
S06.9X4S Unspecified intracranial injury with loss of consciousness of 6 hours to 24 hours, sequela
S06.9X5S Unspecified intracranial injury with loss of consciousness greater than 24 hours with return to pre-existing conscious level, sequela
S06.9X9S Unspecified intracranial injury with loss of consciousness of unspecified duration, sequela
S11.012S Laceration with foreign body of larynx, sequela
S11.014S Puncture wound with foreign body of larynx, sequela
S11.019S Unspecified open wound of larynx, sequela
S11.022S Laceration with foreign body of trachea, sequela
S11.029S Unspecified open wound of trachea, sequela
S11.032S Laceration with foreign body of vocal cord, sequela
S11.034S Puncture wound with foreign body of vocal cord, sequela
S11.22XS Laceration with foreign body of pharynx and cervical esophagus, sequela
S11.24XS Puncture wound with foreign body of pharynx and cervical esophagus, sequela
S12.8XXS Fracture of other parts of neck, sequela
T17.308S Unspecified foreign body in larynx causing other injury, sequela
T17.318S Gastric contents in larynx causing other injury, sequela
T17.328S Food in larynx causing other injury, sequela
T17.398S Other foreign object in larynx causing other injury, sequela
T17.408S Unspecified foreign body in trachea causing other injury, sequela
T17.418S Gastric contents in trachea causing other injury, sequela
T17.428S Food in trachea causing other injury, sequela
T17.498S Other foreign object in trachea causing other injury, sequela
T17.508S Unspecified foreign body in bronchus causing other injury, sequela
T17.518S Gastric contents in bronchus causing other injury, sequela
T17.528S Food in bronchus causing other injury, sequela
T17.598S Other foreign object in bronchus causing other injury, sequela
Z43.0 Encounter for attention to tracheostomy
Z44.8 Encounter for fitting and adjustment of other external prosthetic devices
Z85.21 Personal history of malignant neoplasm of larynx
Z96.3 Presence of artificial larynx
Z97.4 Presence of external hearing-aid
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ICD-10-CM Codes that DO NOT Support Medical Necessity

Group 1

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Group 1 Codes

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ICD-10-PCS Codes

Group 1

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Group 1 Codes

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Additional ICD-10 Information

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Bill Type Codes

Contractors may specify Bill Types to help providers identify those Bill Types typically used to report this service. Absence of a Bill Type does not guarantee that the article does not apply to that Bill Type. Complete absence of all Bill Types indicates that coverage is not influenced by Bill Type and the article should be assumed to apply equally to all claims.

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Revenue Codes

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Other Coding Information

Group 1

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Group 1 Codes

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Coding Table Information

Excluded CPT/HCPCS Codes - Table Format
Code Descriptor Generic Name Descriptor Brand Name Exclusion Effective Date Exclusion End Date Reason for Exclusion
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Non-Excluded CPT/HCPCS Ended Codes - Table Format
Code Descriptor Generic Name Descriptor Brand Name Exclusion Effective Date Exclusion End Date Reason for Exclusion
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Revision History Information

Revision History Date Revision History Number Revision History Explanation
10/01/2024 R11

Under ICD-10-CM Codes that Support Medical Necessity Group 1: Codes added G40.841, G40.842, G40.843, G40.844 and R41.85. This revision is due to the Annual ICD-10-CM Update and will become effective on 10/1/24.

01/01/2024 R10

Under CPT/HCPCS Codes Group 1: Codes added 97550, 97551, and 97552. This revision is due to the 2024 Annual/Q1 CPT/HCPCS Code Update and is retroactive effective for dates of service on or after 1/1/24.

10/01/2023 R9

Under ICD-10-CM Codes that Support Medical Necessity Group 1: Codes deleted G37.8 and added G31.80, E75.27, E75.28 and G37.89. This revision is due to the Annual ICD-10-CM Update and will become effective on 10/01/23.

12/08/2022 R8

Under CMS National Coverage Policy deleted the following: CMS Manual System, Pub. 100-04, Medicare Claims Processing Manual, Transmittal 3924, dated November 16, 2017, Change Request 10303 and CMS Manual System, Pub. 100-20, One-Time Notification, Transmittal 477, dated April 24, 2009, Change Request 6338.

10/01/2022 R7

Under ICD-10-CM Codes that Support Medical Necessity Group 1: Codes deleted F02.81, F03.91, added S06.1XAA, S06.1XAD, S06.1XAS, S06.2XAA, S06.2XAD, S06.2XAS, S06.31AA, S06.31AD, S06.31AS, S06.32AA, S06.32AD, S06.32AS, S06.33AA, S06.33AD, S06.33AS, S06.34AA, S06.34AD, S06.34AS, S06.35AA, S06.35AD, S06.35AS, S06.36AA, S06.36AD, S06.36AS, S06.37AA, S06.37AD, S06.37AS, S06.38AA, S06.38AD, S06.38AS, S06.4XAA, S06.4XAD, S06.4XAS, S06.5XAA, S06.5XAD, S06.5XAS, S06.6XAA, S06.6XAD, S06.6XAS, S06.89AA, S06.89AD, S06.89AS, S06.8A0A, S06.8A0D, S06.8A0S, S06.8A1A, S06.8A1D, S06.8A1S, S06.8A2A, S06.8A2D, S06.8A2S, S06.8A3A, S06.8A3D, S06.8A3S, S06.8A4A, S06.8A4D, S06.8A4S, S06.8A5A, S06.8A5D, S06.8A5S, S06.8A6A, S06.8A6D, S06.8A6S, S06.8A7A, S06.8A8A, S06.8A9A, S06.8A9D, S06.8A9S, S06.8AAA, S06.8AAD, S06.8AAS, F01.518, F01.A18, F01.B18, F01.C18, F02.818, F02.A18, F02.B18, F02.C18 and the description was revised for G31.09 and G31.83. This revision is due to the Annual ICD-10-CM Update and will become effective on 10/1/22.

10/01/2021 R6

Under CMS National Coverage Policy updated section headings for regulations. This revision will become effective 10/1/21.

Under ICD-10-CM Codes that Support Medical Necessity Group 1: Codes deleted R63.3, added R05.8 and R63.39, and the description was revised for G71.20. This revision is due to the Annual ICD-10 Update and will become effective on 10/1/21.

01/01/2021 R5

Under CPT/HCPCS Codes Group 1: Codes added 92517, 92518, 92519, 92650, 92651, 92652 and 92653. This revision is due to the Q1 2021 CPT/HCPCS Code Update and is retroactive effective for dates of service on or after 1/1/2021.

10/01/2020 R4

Under ICD-10 Codes that Support Medical Necessity Group 1: Codes added G40.42, G40.833, G40.834, G71.20, G71.21, G71.220, G71.228 and G71.29. This revision is due to the Annual ICD-10 Code Update and is effective on 10/1/20.

01/01/2020 R3

Under CPT/HCPCS Codes Group 1: Codes CPT® codes 97129 and 97130 were added, G0515 was deleted, and the description changed for 92626 and 92627. This revision is due to the 2020 Annual CPT/HCPCS Code Update and is effective on January 1, 2020.

10/24/2019 R2

This article is being revised in order to adhere to CMS requirements per chapter 13, section 13.5.1 of the Program Integrity Manual, to remove all coding from LCDs and incorporate into related Billing and Coding Articles. Regulations regarding billing and coding were removed from the CMS National Coverage Policy section of the related Outpatient Speech Language Pathology L34429 LCD and placed in this article.

08/15/2019 R1

All coding located in the Coding Information section has been removed from the related Outpatient Speech Language Pathology L34429 LCD and added to this article.

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Associated Documents

Medicare BPM Ch 15.50.2 SAD Determinations
Medicare BPM Ch 15.50.2
Related Local Coverage Documents
LCDs
L34429 - Outpatient Speech Language Pathology
Related National Coverage Documents
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SAD Process URL 1
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SAD Process URL 2
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Statutory Requirements URLs
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Rules and Regulations URLs
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CMS Manual Explanations URLs
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Updated On Effective Dates Status
08/26/2024 10/01/2024 - N/A Currently in Effect You are here
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09/05/2023 10/01/2023 - 12/31/2023 Superseded View
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Keywords

  • Speech Language Pathology