8.01.34 therapy for dysphagia

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8.01.34 THERAPY FOR DYSPHAGIA

Section

Therapy

Original Date

August 19, 2013

Subsection

Revision Date

June 22, 2016

“This policy is protected by copyright under federal laws and/or intellectual property laws and state

regulations. No part of this publication may be reproduced, stored in a retrieval system, transmitted in any

form or by any means, either electronic, mechanical, photocopying, recording, or otherwise, without the

written permission of the health plan.”

Definition Dysphagia, therapy for swallowing, is a medical treatment indicated to improve or restore the functions of swallowing that have been altered by a disease or injury. Phases of swallowing include oral, pharynx and/or esophagus (upper third). Dysphagia is a disorder of swallowing which may be due to diverse neurological, structural and cognitive deficiencies. Dysphagia may result from traumatic brain injury, stroke, neuromuscular degenerative diseases, cancer of the head and neck and encephalopathies. While dysphagia can affect any age group, it appears more frequently in the elderly. Background The diagnosis of dysphagia or difficulty to swallow, requires an extensive evaluation by the physician. Many problems can be identified and treated on the basis of the results of this test alone. In some cases, more extensive assessments are required using a variety of studies such as ultrasound and studies of modified barium swallow and an evaluation by a therapist of swallowing. Treatment of dysphagia/difficulty to swallow may include simple recommendations for things, such as the consistency of the food or its placement in the mouth, or may require a treatment program aimed at the achievement of a functional improvement.

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Patients who are motivated, are moderately alert and have some degree of swallowing are suitable candidates for dysphagia therapy. The elements of the therapy program can include thermal stimulation to increase the sensitivity of the reflex of swallowing, exercises to improve the motor-oral control, training in the adduction of larynx and the techniques of compensatory swallowing, and the positioning and modifications in the diet. To design programs to ensure the safety of the patient’s swallowing during oral feeding and maintain adequate nutrition. Dysphagia can be caused by any condition that weakens or damages the nerves and muscles used for swallowing. For example, people with diseases of the nervous system, such as cerebral palsy or Parkinson's disease, often have problems swallowing. In addition, a stroke or traumatic brain injury can affect the coordination of muscles of swallowing or a feeling of limit in the mouth and throat. An infection or irritation can cause narrowing of the esophagus. People who are born with abnormalities in the swallowing mechanism may not be able to swallow normally. Babies who are born with cleft palates are not able to suck properly, which complicates the breastfeeding and be able to take a regular bottle. In addition, the head, neck, or esophageal cancers can cause dysphagia. Sometimes, the treatment for these types of cancer can cause dysphagia. The head, neck and chest injuries can also create problems swallowing. The physician must establish a preliminary diagnosis to address the symptoms associated with dysphagia. This preliminary diagnosis must address the possibility of treatment of the patient in terms of:

Alertness level Capacity to cooperate Capacity to retain new knowledge Cognitive state Medical stability Psychological stability

There must be a significant and recent change on the basis of swallowing to consider an assessment of dysphagia medically necessary. One or more of the following conditions must be present:

History of the problems of aspiration or definite risk of aspiration.

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Insufficient capacity of the salivary glands and/or presence of local structural lesions in the pharynx that produce significant difficulties in oropharyngeal swallowing.

Lack of coordination, loss of sensation, postural difficulties or other disorders affecting

the neuro-motor oropharyngeal skills necessary to close the mouth cavity and/or bite, chew, suck, the form and consolidation of the bolus in the upper esophagus, while protecting the airway.

Post-surgical reaction.

Significant weight loss directly related to the oral intake reduced as a consequence of

dysphagia.

It is considered significant weight loss, when your usual weight loses:

.>2% in a week 5% in a month >10% in 6 months >20% in a year

Policy Therapy for the treatment of dysphagia proceeds for payment when any of the following criteria have been met:

Weight loss or malnutrition due to inability to obtain an adequate nutrition orally, or

History, or being at high risk of having recurrent aspirations or suffocation, or

The patient is incapable of swallowing and has a probe nasogastric tube or gastrostomy for nutrition.

Therapy for dysphagia does not proceed for payment for all other indications, since its effectiveness for indications other than those mentioned above, has not been established. Esophageal dilatation proceeds to payment for the treatment of symptomatic obstruction of the esophagus. Esophageal dilatation for treatment of non-obstructive esophageal dysphagia does not proceed for payment, since their efficacy has not been established.

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The placement of a stent proceeds for payment in cases of refractory stenosis (it cannot be dilated up to a suitable diameter), such as malignant esophageal stenosis. The following interventions, but not limited to these only, do not proceed for payment for the treatment of dysphagia because their efficacy in these indications has not been established:

Botulinum toxin Electric stimulation Pharyngeal motor cortex stimulation Repetitive transcranial magnetic stimulation

Codes

Covered

CPT Description

92526 Treatment of swallowing dysfunction and/or oral function for feeding

92610 Evaluation of oral and pharyngeal swallowing function

92611 Motion fluoroscopic evaluation of swallowing function by cine or video recording

92612 Flexible fiberoptic endoscopic evaluation of swallowing by cine or video

recording

92613 Flexible fiberoptic endoscopic evaluation of swallowing by cine or video

recording; physician interpretation and report only

43213 With dilation of esophagus, by balloon or dilator, retrograde (includes

fluoroscopic guidance, when performed)

43214 With dilation of esophagus with balloon (30mm diameter or larger) (includes

fluoroscopic guidance, when performed)

43220 Esophagoscopy, rigid or flexible; with balloon dilation (less than 30 mm

diameter)

43226 Esophagoscopy, rigid or flexible; with insertion of guide wire followed by dilation

over guide wire

43233 With dilation of esophagus with balloon (30 mm diameter or larger) (includes

fluoroscopic guidances, ehen performed)

43249 Upper gastrointestinal endoscopy including esophagus, stomach, and either the

duodenum and/or jejunum as appropriate; with balloon dilation of esophagus

(less than 30 mm diameter)

43450 Dilation of esophagus, by unguided sound or bougie, single or multiple passes

43453 Dilation of esophagus, over guide wire

CPT no

cubiertos Description

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64550 Application of surface (transcutaneous) neurostimulator

64612 Chemodenervation of muscle(s); muscle(s) innervated by facial nerve (eg, for

blepharospasm, hemifacial spasm)

64616 neck muscle (s), excluding muscles of the larynx, unilateral (eg. For cervical

dystonia, spasmodic torticollis).

90867 Therapeutic repetitive transcranial magnetic stimulation (TMS) treatment; initial,

including cortical mapping, motor threshold determination, delivery and

management

90868 Therapeutic repetitive transcranial magnetic stimulation (TMS) treatment;

subsequent delivery and management, per session

90869 Therapeutic repetitive transcranial magnetic stimulation (TMS) treatment;

subsequent motor threshold re-determination with delivery and management

95873 Electrical stimulation for guidance in conjunction with chemodenervation (List

separately in addition to code for primary procedure)

95874 95874Needle electromyography for guidance in conjunction with

chemodenervation (List separately in addition to code for primary procedure)

97014 Application of a modality to 1 or more areas; electrical stimulation (unattended)

97032 Application of a modality to 1 or more areas; electrical stimulation (manual),

each 15 minutes

ICD-9

(Termination date

09/30/2015

Description ICD-10-CM

(effective

10/01/15)

Description

141.0 Malignant neoplasm of

base of tongue

C01 Malignant neoplasm of base of tongue


dorsal surface of tongue

C02.0 Malignant neoplasm of dorsal surface of

tongue

141.2 Malignant neoplasm of tip

and lateral border of

tongue

C02.1 Malignant neoplasm of border of tongue


ventral surface of tongue

C02.2 Malignant neoplasm of ventral surface of

tongue


anterior two-thirds of

tongue, part unspecified

C02.3 Malignant neoplasm of anterior two-thirds

of tongue, part unspecified


junctional zone of tongue

C02.8 Malignant neoplasm of overlapping sites of

tongue


lingual tonsil

C02.4 Malignant neoplasm of lingual tonsil


other sites of tongue


tongue

141.9 Malignant neoplasm of C02.9 Malignant neoplasm of tongue, unspecified

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tongue, unspecified


parotid gland

C07 Malignant neoplasm of parotid gland


submandibular gland

C08.0 Malignant neoplasm of submandibular

gland


sublingual gland

C08.1 Malignant neoplasm of sublingual gland


other major salivary glands

C08.9 Malignant neoplasm of major salivary

gland, unspecified


salivary gland, unspecified

C08.9 Malignant neoplasm of major salivary

gland, unspecified


upper gum

C03.0 Malignant neoplasm of upper gum


lower gum

C03.1 Malignant neoplasm of lower gum


other sites of gum

C03.9 Malignant neoplasm of gum, unspecified


gum, unspecified

C03.9 Malignant neoplasm of gum, unspecified


anterior portion of floor of

mouth

C04.0 Malignant neoplasm of anterior floor of

mouth


lateral portion of floor of

mouth

C04.1 Malignant neoplasm of lateral floor of

mouth


other sites of floor of

mouth


floor of mouth


floor of mouth, part

unspecified

C04.9 Malignant neoplasm of floor of mouth,

unspecified


cheek mucosa

C06.0 Malignant neoplasm of cheek mucosa


vestibule of mouth

C06.1 Malignant neoplasm of vestibule of mouth


hard palate

C05.0 Malignant neoplasm of hard palate

145.3 Malignant neoplasm of soft

palate

C05.1 Malignant neoplasm of soft palate


uvula

C05.2 Malignant neoplasm of uvula


palate, unspecified


palate

C05.9 Malignant neoplasm of palate, unspecified


retromolar area

C06.2 Malignant neoplasm of retromolar area

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other specified parts of

mouth


other parts of mouth


mouth, unspecified

C06.9 Malignant neoplasm of mouth, unspecified


tonsil


tonsil

C09.9 Malignant neoplasm of tonsil, unspecified


tonsillar fossa

C09.0 Malignant neoplasm of tonsillar fossa


tonsillar pillars (anterior)

(posterior)

C09.1 Malignant neoplasm of tonsillar pillar

(anterior) (posterior)


vallecula epiglottica

C10.0 Malignant neoplasm of vallecula


anterior aspect of epiglottis

C10.1 Malignant neoplasm of anterior surface of

epiglottis


junctional region of

oropharynx


oropharynx


lateral wall of oropharynx

C10.2 Malignant neoplasm of lateral wall of

oropharynx

C10.3 Malignant neoplasm of posterior wall of

oropharynx


oropharynx

C10.9 Malignant neoplasm of oropharynx,

unspecified


posterior wall of

oropharynx


oropharynx


other specified sites of

oropharynx

C10.4 Malignant neoplasm of branchial cleft


oropharynx


oropharynx, unspecified

site


oropharynx


oropharynx


oropharynx

C10.9 Malignant neoplasm of oropharynx,

unspecified

147.0 Malignant neoplasm of C11.0 Malignant neoplasm of superior wall of

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superior wall of

nasopharynx

nasopharynx


posterior wall of

nasopharynx


nasopharynx


lateral wall of nasopharynx


nasopharynx


anterior wall of

nasopharynx

C11.3 Malignant neoplasm of anterior wall of

nasopharynx



nasopharynx


nasopharynx


nasopharynx, unspecified

site

C11.9 Malignant neoplasm of nasopharynx,

unspecified


postcricoid region of

hypopharynx

C13.0 Malignant neoplasm of postcricoid region


pyriform sinus

C12 Malignant neoplasm of pyriform sinus


aryepiglottic fold,

hypopharyngeal aspect

C13.1 Malignant neoplasm of aryepiglottic fold,

hypopharyngeal aspect


posterior hypopharyngeal

wall


hypopharynx



hypopharynx


hypopharynx


hypopharynx, unspecified

site

C13.9 Malignant neoplasm of hypopharynx,

unspecified


pharynx, unspecified

C14.0 Malignant neoplasm of pharynx,

unspecified


waldeyer's ring

C14.2 Malignant neoplasm of Waldeyer's ring


other sites within the lip

and oral cavity

C00.0 Malignant neoplasm of external upper lip

C00.1 Malignant neoplasm of external lower lip

C00.2 Malignant neoplasm of external lip,

unspecified

C00.3 Malignant neoplasm of upper lip, inner

aspect

C00.4 Malignant neoplasm of lower lip, inner

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aspect

C00.5 Malignant neoplasm of lip, unspecified,

inner aspect

C00.6 Malignant neoplasm of commissure of lip,

unspecified


lip

C00.9 Malignant neoplasm of lip, unspecified








palate






lip, oral cavity and pharynx

149.9 Malignant neoplasm of ill-

defined sites within the lip

and oral cavity

C00.0 Malignant neoplasm of external upper lip

C00.1 Malignant neoplasm of external lower lip

C00.2 Malignant neoplasm of external lip,

unspecified

C00.3 Malignant neoplasm of upper lip, inner

aspect

C00.4 Malignant neoplasm of lower lip, inner

aspect

C00.5 Malignant neoplasm of lip, unspecified,

inner aspect

C00.6 Malignant neoplasm of commissure of lip,

unspecified


lip

C00.9 Malignant neoplasm of lip, unspecified

C01 Malignant neoplasm of base of tongue

C02.0 Malignant neoplasm of dorsal surface of

tongue

C02.1 Malignant neoplasm of border of tongue

C02.2 Malignant neoplasm of ventral surface of

tongue

C02.3 Malignant neoplasm of anterior two-thirds

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of tongue, part unspecified



tongue

C02.9 Malignant neoplasm of tongue, unspecified







palate






lip, oral cavity and pharynx


cervical esophagus

C15.3 Malignant neoplasm of upper third of

esophagus


thoracic esophagus

C15.4 Malignant neoplasm of middle third of

esophagus


abdominal esophagus

C15.5 Malignant neoplasm of lower third of

esophagus


upper third of esophagus

C15.3 Malignant neoplasm of upper third of

esophagus


middle third of esophagus

C15.4 Malignant neoplasm of middle third of

esophagus


lower third of esophagus

C15.5 Malignant neoplasm of lower third of

esophagus


other specified part of

esophagus


esophagus


esophagus, unspecified

site

C15.9 Malignant neoplasm of esophagus,

unspecified


glottis

C32.0 Malignant neoplasm of glottis


supraglottis

C32.1 Malignant neoplasm of supraglottis


subglottis

C32.2 Malignant neoplasm of subglottis


laryngeal cartilages

C32.3 Malignant neoplasm of laryngeal cartilage




larynx

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larynx


larynx, unspecified

C32.9 Malignant neoplasm of larynx, unspecified


trachea

C33 Malignant neoplasm of trachea

260 Kwashiorkor E40 Kwashiorkor

E42 Marasmic kwashiorkor

261 Nutritional marasmus E41 Nutritional marasmus

261 Nutritional marasmus E43 Unspecified severe protein-calorie

malnutrition

262 Other severe protein-

calorie malnutrition

E41 Nutritional marasmus

E43 Unspecified severe protein-calorie

malnutrition

263.0 Malnutrition of moderate

degree

E44.0 Moderate protein-calorie malnutrition

263.1 Malnutrition of mild degree E44.1 Mild protein-calorie malnutrition

263.2 Arrested development

following protein-calorie

malnutrition

E45 Retarded development following protein-


263.8 Other protein-calorie

malnutrition

E41 Nutritional marasmus

E43 Unspecified severe protein-calorie

malnutrition

E44.0 Moderate protein-calorie malnutrition

E44.1 Mild protein-calorie malnutrition

E45 Retarded development following protein-


E46 Unspecified protein-calorie malnutrition

E64.0 Sequelae of protein-calorie malnutrition

263.9 Unspecified protein-calorie

malnutrition

E46 Unspecified protein-calorie malnutrition

332.0 Paralysis agitans G20 Parkinson's disease

G21.11 Neuroleptic induced parkinsonism

G21.3 Postencephalitic parkinsonism

G21.4 Vascular parkinsonism

332.1 Secondary parkinsonism G21.11 Neuroleptic induced parkinsonism

G21.19 Other drug induced secondary

parkinsonism

G21.2 Secondary parkinsonism due to other

external agents

G21.3 Postencephalitic parkinsonism

G21.8 Other secondary parkinsonism

G21.9 Secondary parkinsonism, unspecified

430 Subarachnoid hemorrhage I60.00 Nontraumatic subarachnoid hemorrhage

from unspecified carotid siphon and

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bifurcation

I60.01 Nontraumatic subarachnoid hemorrhage

from right carotid siphon and bifurcation


from left carotid siphon and bifurcation


from unspecified middle cerebral artery


from right middle cerebral artery


from left middle cerebral artery


from unspecified anterior communicating

artery


from right anterior communicating artery


from left anterior communicating artery


from unspecified posterior communicating

artery


from right posterior communicating artery


from left posterior communicating artery


from basilar artery


from unspecified vertebral artery


from right vertebral artery


from left vertebral artery


from other intracranial arteries


from unspecified intracranial artery

I60.8 Other nontraumatic subarachnoid

hemorrhage

I60.9 Nontraumatic subarachnoid hemorrhage,

unspecified

I69.098 Other sequelae following nontraumatic

subarachnoid hemorrhage

431 Intracerebral hemorrhage I61.0 Nontraumatic intracerebral hemorrhage in

hemisphere, subcortical

I61.1 Nontraumatic intracerebral hemorrhage in

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hemisphere, cortical


hemisphere, unspecified


brain stem


cerebellum

I61.5 Nontraumatic intracerebral hemorrhage,

intraventricular


multiple localized

I61.8 Other nontraumatic intracerebral

hemorrhage


unspecified

432.0 Nontraumatic extradural

hemorrhage

I62.00 Nontraumatic subdural hemorrhage,

unspecified

I62.01 Nontraumatic acute subdural hemorrhage

I62.02 Nontraumatic subacute subdural

hemorrhage

I62.03 Nontraumatic chronic subdural hemorrhage

I62.1 Nontraumatic extradural hemorrhage

I62.9 Nontraumatic intracranial hemorrhage,

unspecified

432.1 Subdural hemorrhage I62.00 Nontraumatic subdural hemorrhage,

unspecified

I62.01 Nontraumatic acute subdural hemorrhage

I62.02 Nontraumatic subacute subdural

hemorrhage

I62.03 Nontraumatic chronic subdural hemorrhage


unspecified

432.9 Unspecified intracranial

hemorrhage

I62.00 Nontraumatic subdural hemorrhage,

unspecified


unspecified

433.00 Occlusion and stenosis of

basilar artery without

mention of cerebral

infarction

I65.1 Occlusion and stenosis of basilar artery


basilar artery with cerebral

infarction

I63.02 Cerebral infarction due to thrombosis of

basilar artery

I63.12 Cerebral infarction due to embolism of

basilar artery

I63.22 Cerebral infarction due to unspecified

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occlusion or stenosis of basilar arteries


carotid artery without

mention of cerebral

infarction

I65.21 Occlusion and stenosis of right carotid

artery

I65.22 Occlusion and stenosis of left carotid artery

I65.23 Occlusion and stenosis of bilateral carotid

arteries

I65.29 Occlusion and stenosis of unspecified

carotid artery


carotid artery with cerebral

infarction


right carotid artery

I63.032 Cerebral infarction due to thrombosis of left

carotid artery


unspecified carotid artery

I63.131 Cerebral infarction due to embolism of right

carotid artery

I63.132 Cerebral infarction due to embolism of left

carotid artery


unspecified carotid artery


occlusion or stenosis of right carotid

arteries


occlusion or stenosis of left carotid arteries


occlusion or stenosis of unspecified carotid

arteries


vertebral artery without

mention of cerebral

infarction

I65.01 Occlusion and stenosis of right vertebral

artery

I65.02 Occlusion and stenosis of left vertebral

artery

I65.03 Occlusion and stenosis of bilateral vertebral

arteries


vertebral artery


vertebral artery with

cerebral infarction


right vertebral artery


vertebral artery

of 136


unspecified vertebral artery


vertebral artery


vertebral artery


unspecified vertebral artery


occlusion or stenosis of right vertebral

arteries


occlusion or stenosis of left vertebral

arteries


occlusion or stenosis of unspecified

vertebral arteries


multiple and bilateral

precerebral arteries

without mention of

cerebral infarction

I65.8 Occlusion and stenosis of other precerebral

arteries


multiple and bilateral

precerebral arteries with

cerebral infarction


occlusion or stenosis of other cerebral

artery


other specified precerebral

artery without mention of

cerebral infarction

I65.8 Occlusion and stenosis of other precerebral

arteries


other specified precerebral

artery with cerebral

infarction


other precerebral artery


other precerebral artery



artery


unspecified precerebral

artery without mention of

cerebral infarction


precerebral artery


unspecified precerebral

artery with cerebral


unspecified precerebral artery

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infarction


unspecified precerebral artery



precerebral arteries


occlusion or stenosis of other precerebral

arteries

434.00 Cerebral thrombosis

without mention of

cerebral infarction

I66.01 Occlusion and stenosis of right middle

cerebral artery

I66.02 Occlusion and stenosis of left middle

cerebral artery

I66.03 Occlusion and stenosis of bilateral middle

cerebral arteries


middle cerebral artery

I66.11 Occlusion and stenosis of right anterior

cerebral artery

I66.12 Occlusion and stenosis of left anterior

cerebral artery

I66.13 Occlusion and stenosis of bilateral anterior

cerebral arteries


anterior cerebral artery

I66.21 Occlusion and stenosis of right posterior

cerebral artery

I66.22 Occlusion and stenosis of left posterior

cerebral artery

I66.23 Occlusion and stenosis of bilateral posterior

cerebral arteries


posterior cerebral artery

I66.3 Occlusion and stenosis of cerebellar

arteries

I66.8 Occlusion and stenosis of other cerebral

arteries


cerebral artery

434.01 Cerebral thrombosis with

cerebral infarction


unspecified cerebral artery


right middle cerebral artery



of 136


unspecified middle cerebral artery


right anterior cerebral artery




unspecified anterior cerebral artery


right posterior cerebral artery




unspecified posterior cerebral artery


right cerebellar artery


cerebellar artery


unspecified cerebellar artery


other cerebral artery

434.10 Cerebral embolism without

mention of cerebral

infarction


cerebral artery


cerebral artery


cerebral arteries


cerebral artery


cerebral artery


cerebral arteries


cerebral artery


cerebral artery


cerebral arteries


arteries


arteries

434.11 Cerebral embolism with I63.40 Cerebral infarction due to embolism of

of 136

cerebral infarction unspecified cerebral artery






unspecified middle cerebral artery






unspecified anterior cerebral artery






unspecified posterior cerebral artery


cerebellar artery


cerebellar artery


unspecified cerebellar artery





cerebral artery


occlusion or stenosis of left middle cerebral

artery


occlusion or stenosis of unspecified middle

cerebral artery


occlusion or stenosis of left anterior

cerebral artery





occlusion or stenosis of right posterior

cerebral artery


of 136

occlusion or stenosis of left posterior

cerebral artery

434.90 Cerebral artery occlusion,

unspecified without

mention of cerebral

infarction


cerebral artery


cerebral artery


cerebral arteries




cerebral artery


cerebral artery


cerebral arteries




cerebral artery


cerebral artery


cerebral arteries




arteries


arteries


cerebral artery

434.91 Cerebral artery occlusion,

unspecified with cerebral

infarction











cerebral artery

of 136


occlusion or stenosis of right middle

cerebral artery


occlusion or stenosis of left middle cerebral

artery


occlusion or stenosis of unspecified middle

cerebral artery


occlusion or stenosis of right anterior

cerebral artery


occlusion or stenosis of left anterior

cerebral artery





occlusion or stenosis of right posterior

cerebral artery


occlusion or stenosis of left posterior

cerebral artery





occlusion or stenosis of right cerebellar

artery


occlusion or stenosis of left cerebellar

artery



cerebellar artery



artery

I63.8 Other cerebral infarction

I63.9 Cerebral infarction, unspecified

435.0 Basilar artery syndrome G45.0 Vertebro-basilar artery syndrome

435.1 Vertebral artery syndrome G45.0 Vertebro-basilar artery syndrome

435.2 Subclavian steal syndrome G45.8 Other transient cerebral ischemic attacks

and related syndromes

435.3 Vertebrobasilar artery G45.0 Vertebro-basilar artery syndrome

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syndrome

435.8 Other specified transient

cerebral ischemias

G45.1 Carotid artery syndrome (hemispheric)

G45.2 Multiple and bilateral precerebral artery

syndromes

G45.8 Other transient cerebral ischemic attacks

and related syndromes

G46.0 Middle cerebral artery syndrome

G46.1 Anterior cerebral artery syndrome

G46.2 Posterior cerebral artery syndrome

435.9 Unspecified transient

cerebral ischemia

G45.9 Transient cerebral ischemic attack,

unspecified

I67.848 Other cerebrovascular vasospasm and

vasoconstriction

436 Acute, but ill-defined,

cerebrovascular disease

I67.82 Cerebral ischemia

I67.89 Other cerebrovascular disease

I68.0 Cerebral amyloid angiopathy

437.0 Cerebral atherosclerosis I67.2 Cerebral atherosclerosis

437.1 Other generalized

ischemic cerebrovascular

disease

I67.81 Acute cerebrovascular insufficiency

I67.82 Cerebral ischemia


437.2 Hypertensive

encephalopathy

I67.4 Hypertensive encephalopathy

437.3 Cerebral aneurysm,

nonruptured

I67.1 Cerebral aneurysm, nonruptured

437.4 Cerebral arteritis I67.7 Cerebral arteritis, not elsewhere classified

I68.2 Cerebral arteritis in other diseases

classified elsewhere

437.5 Moyamoya disease I67.5 Moyamoya disease

437.6 Nonpyogenic thrombosis

of intracranial venous

sinus

I67.6 Nonpyogenic thrombosis of intracranial

venous system

437.7 Transient global amnesia G45.4 Transient global amnesia

437.8 Other ill-defined


G46.3 Brain stem stroke syndrome

G46.4 Cerebellar stroke syndrome

G46.5 Pure motor lacunar syndrome

G46.6 Pure sensory lacunar syndrome

G46.7 Other lacunar syndromes

G46.8 Other vascular syndromes of brain in

cerebrovascular diseases


I68.0 Cerebral amyloid angiopathy

of 136

I68.8 Other cerebrovascular disorders in

diseases classified elsewhere

437.9 Unspecified


I63.8 Other cerebral infarction

I67.9 Cerebrovascular disease, unspecified

I69.90 Unspecified sequelae of unspecified


I69.920 Aphasia following unspecified


I69.921 Dysphasia following unspecified


I69.922 Dysarthria following unspecified


I69.923 Fluency disorder following unspecified


I69.961 Other paralytic syndrome following

unspecified cerebrovascular disease

affecting right dominant side



affecting left dominant side



affecting right non-dominant side



affecting left non-dominant side


unspecified cerebrovascular disease,

bilateral



affecting unspecified side

I69.990 Apraxia following unspecified


I69.991 Dysphagia following unspecified


I69.992 Facial weakness following unspecified


I69.993 Ataxia following unspecified


438.0 Late effects of

cerebrovascular disease,

cognitive deficits

I69.01 Cognitive deficits following nontraumatic


I69.11 Cognitive deficits following nontraumatic

intracerebral hemorrhage

of 136

I69.21 Cognitive deficits following other

nontraumatic intracranial hemorrhage

I69.31 Cognitive deficits following cerebral

infarction

I69.81 Cognitive deficits following other


I69.91 Cognitive deficits following unspecified




speech and language

deficit, unspecified

I69.328 Other speech and language deficits

following cerebral infarction


following other cerebrovascular disease


following unspecified cerebrovascular

disease



aphasia

I69.020 Aphasia following nontraumatic


I69.120 Aphasia following nontraumatic


I69.220 Aphasia following other nontraumatic

intracranial hemorrhage

I69.320 Aphasia following cerebral infarction

I69.820 Aphasia following other cerebrovascular

disease

I69.898 Other sequelae of other cerebrovascular

disease

I69.920 Aphasia following unspecified




dysphasia

I69.021 Dysphasia following nontraumatic


I69.121 Dysphasia following nontraumatic


I69.221 Dysphasia following other nontraumatic


I69.321 Dysphasia following cerebral infarction

I69.821 Dysphasia following other cerebrovascular

disease


disease

I69.921 Dysphasia following unspecified


438.13 Late effects of I69.022 Dysarthria following nontraumatic

of 136


dysarthria


I69.122 Dysarthria following nontraumatic


I69.222 Dysarthria following other nontraumatic


I69.322 Dysarthria following cerebral infarction

I69.822 Dysarthria following other cerebrovascular

disease

I69.922 Dysarthria following unspecified




fluency disorder

I69.023 Fluency disorder following nontraumatic


I69.123 Fluency disorder following nontraumatic


I69.223 Fluency disorder following other


I69.323 Fluency disorder following cerebral

infarction

I69.823 Fluency disorder following other


I69.923 Fluency disorder following unspecified




other speech and

language deficits


following nontraumatic subarachnoid

hemorrhage


following nontraumatic intracerebral

hemorrhage


following other nontraumatic intracranial

hemorrhage


following cerebral infarction


following other cerebrovascular disease



disease



hemiplegia affecting

unspecified side

I69.059 Hemiplegia and hemiparesis following

nontraumatic subarachnoid hemorrhage



of 136

nontraumatic intracerebral hemorrhage


I69.259 Hemiplegia and hemiparesis following other




cerebral infarction affecting unspecified

side


cerebrovascular disease affecting

unspecified side







dominant side




















cerebral infarction affecting right dominant

side


cerebral infarction affecting left dominant

side


cerebrovascular disease affecting right

dominant side


cerebrovascular disease affecting left

dominant side


of 136









nondominant side




















cerebral infarction affecting right non-

dominant side


cerebral infarction affecting left non-

dominant side



non-dominant side


cerebrovascular disease affecting left non-

dominant side









monoplegia of upper limb


I69.039 Monoplegia of upper limb following



of 136










I69.233 Monoplegia of upper limb following other









I69.339 Monoplegia of upper limb following cerebral

infarction affecting unspecified side



unspecified side







affecting dominant side




















of 136

infarction affecting right dominant side


infarction affecting left dominant side



dominant side



dominant side










affecting nondominant side




















infarction affecting right non-dominant side


infarction affecting left non-dominant side



non-dominant side



dominant side



of 136







monoplegia of lower limb


I69.049 Monoplegia of lower limb following






I69.249 Monoplegia of lower limb following other



I69.349 Monoplegia of lower limb following cerebral




unspecified side































of 136


dominant side



dominant side



































non-dominant side



dominant side







of 136



other paralytic syndrome








I69.269 Other paralytic syndrome following other



I69.369 Other paralytic syndrome following cerebral




unspecified side
































dominant side



of 136

dominant side



































non-dominant side



dominant side









other paralytic syndrome,

bilateral


nontraumatic subarachnoid hemorrhage,

bilateral

of 136


nontraumatic intracerebral hemorrhage,

bilateral


nontraumatic intracranial hemorrhage,

bilateral


infarction, bilateral


cerebrovascular disease, bilateral


unspecified cerebrovascular disease,

bilateral



alterations of sensations


disease

I69.998 Other sequelae following unspecified




disturbances of vision


disease



438.81 Other late effects of


apraxia

I69.090 Apraxia following nontraumatic


I69.190 Apraxia following nontraumatic


I69.290 Apraxia following other nontraumatic


I69.390 Apraxia following cerebral infarction

I69.890 Apraxia following other cerebrovascular

disease

I69.990 Apraxia following unspecified




dysphagia

I69.091 Dysphagia following nontraumatic


I69.191 Dysphagia following nontraumatic


I69.291 Dysphagia following other nontraumatic


I69.391 Dysphagia following cerebral infarction

I69.891 Dysphagia following other cerebrovascular

disease

I69.991 Dysphagia following unspecified

of 136




facial weakness

I69.092 Facial weakness following nontraumatic


I69.192 Facial weakness following nontraumatic


I69.292 Facial weakness following other


I69.392 Facial weakness following cerebral

infarction

I69.892 Facial weakness following other


I69.992 Facial weakness following unspecified




ataxia

I69.093 Ataxia following nontraumatic subarachnoid

hemorrhage

I69.193 Ataxia following nontraumatic intracerebral

hemorrhage

I69.293 Ataxia following other nontraumatic


I69.393 Ataxia following cerebral infarction

I69.893 Ataxia following other cerebrovascular

disease

I69.993 Ataxia following unspecified




vertigo


disease





I69.098 Other sequelae following nontraumatic


I69.198 Other sequelae of nontraumatic


I69.298 Other sequelae of other nontraumatic


I69.30 Unspecified sequelae of cerebral infarction

I69.398 Other sequelae of cerebral infarction


disease





disease

of 136



438.9 Unspecified late effects of


I69.00 Unspecified sequelae of nontraumatic


I69.10 Unspecified sequelae of nontraumatic


I69.20 Unspecified sequelae of other nontraumatic


I69.30 Unspecified sequelae of cerebral infarction

I69.80 Unspecified sequelae of other




478.30 Paralysis of vocal cords or

larynx, unspecified

J38.00 Paralysis of vocal cords and larynx,

unspecified


unilateral


bilateral

478.31 Unilateral paralysis of

vocal cords or larynx,

partial


unspecified


unilateral


bilateral

478.32 Unilateral paralysis of

vocal cords or larynx,

complete


unspecified


unilateral


bilateral

478.33 Bilateral paralysis of vocal

cords or larynx, partial


bilateral

478.34 Bilateral paralysis of vocal

cords or larynx, complete


bilateral

530.3 Stricture and stenosis of

esophagus

K22.2 Esophageal obstruction

748.2 Web of larynx Q31.0 Web of larynx

748.3 Other anomalies of larynx,

trachea, and bronchus

Q31.2 Laryngeal hypoplasia

Q31.8 Other congenital malformations of larynx

Q31.9 Congenital malformation of larynx,

unspecified

Q32.1 Other congenital malformations of trachea

of 136

Q32.2 Congenital bronchomalacia

Q32.3 Congenital stenosis of bronchus

Q32.4 Other congenital malformations of

bronchus

749.00 Cleft palate, unspecified Q35.9 Cleft palate, unspecified

Q37.8 Unspecified cleft palate with bilateral cleft

lip

Q37.9 Unspecified cleft palate with unilateral cleft

lip

749.01 Cleft palate, unilateral,

complete

Q35.9 Cleft palate, unspecified

749.02 Cleft palate, unilateral,

incomplete

Q35.7 Cleft uvula


749.03 Cleft palate, bilateral,

complete

Q35.1 Cleft hard palate

Q35.3 Cleft soft palate

Q35.5 Cleft hard palate with cleft soft palate


Q37.0 Cleft hard palate with bilateral cleft lip

Q37.2 Cleft soft palate with bilateral cleft lip

Q37.4 Cleft hard and soft palate with bilateral cleft

lip


lip

749.04 Cleft palate, bilateral,

incomplete



lip

749.10 Cleft lip, unspecified Q36.0 Cleft lip, bilateral

Q36.9 Cleft lip, unilateral

749.11 Cleft lip, unilateral,

complete

Q36.1 Cleft lip, median


749.12 Cleft lip, unilateral,

incomplete


749.13 Cleft lip, bilateral, complete Q36.0 Cleft lip, bilateral

749.14 Cleft lip, bilateral,

incomplete

Q36.0 Cleft lip, bilateral

749.20 Cleft palate with cleft lip,

unspecified


lip


unilateral, complete

Q37.1 Cleft hard palate with unilateral cleft lip

Q37.3 Cleft soft palate with unilateral cleft lip

Q37.5 Cleft hard and soft palate with unilateral

cleft lip

of 136


lip


unilateral, incomplete




cleft lip


lip


bilateral, complete




lip


lip


bilateral, incomplete




lip


lip

749.25 Other combinations of cleft

palate with cleft lip






lip


cleft lip


lip


lip

750.21 Absence of salivary gland Q38.4 Congenital malformations of salivary glands

and ducts

750.22 Accessory salivary gland Q38.4 Congenital malformations of salivary glands

and ducts

750.23 Atresia, salivary duct Q38.4 Congenital malformations of salivary glands

and ducts

750.24 Congenital fistula of

salivary gland

Q38.4 Congenital malformations of salivary glands

and ducts

750.25 Congenital fistula of lip Q38.0 Congenital malformations of lips, not

elsewhere classified

of 136

750.26 Other specified anomalies

of mouth

Q38.6 Other congenital malformations of mouth

750.27 Diverticulum of pharynx Q38.7 Congenital pharyngeal pouch

750.29 Other specified anomalies

of pharynx

Q38.7 Congenital pharyngeal pouch

Q38.8 Other congenital malformations of pharynx

750.3 Tracheoesophageal

fistula, esophageal atresia

and stenosis

Q39.0 Atresia of esophagus without fistula

Q39.1 Atresia of esophagus with tracheo-

esophageal fistula

Q39.2 Congenital tracheo-esophageal fistula

without atresia

787.20 Dysphagia, unspecified R13.10 Dysphagia, unspecified

787.21 Dysphagia, oral phase R13.11 Dysphagia, oral phase

787.22 Dysphagia, oropharyngeal

phase

R13.12 Dysphagia, oropharyngeal phase

787.23 Dysphagia, pharyngeal

phase

R13.13 Dysphagia, pharyngeal phase

787.24 Dysphagia,

pharyngoesophageal

phase

R13.14 Dysphagia, pharyngoesophageal phase

787.29 Other dysphagia R13.19 Other dysphagia

805.9 Open fracture of

unspecified vertebral

column without mention of

spinal cord injury

S12.9xxA Fracture of neck, unspecified, initial

encounter

S22.009B Unspecified fracture of unspecified thoracic

vertebra, initial encounter for open fracture

S32.009B Unspecified fracture of unspecified lumbar

vertebra, initial encounter for open fracture

S32.10xB Unspecified fracture of sacrum, initial

encounter for open fracture

850.0 Concussion with no loss of

consciousness

S06.0X0A Concussion without loss of consciousness,

initial encounter

850.11 Concussion, with loss of

consciousness of 30

minutes or less

S06.0X1A Concussion with loss of consciousness of

30 minutes or less, initial encounter

S06.0X1D Concussion with loss of consciousness of

30 minutes or less, subsequent encounter

S06.0X1S Concussion with loss of consciousness of

30 minutes or less, sequela

850.12 Concussion, with loss of

consciousness from 31 to

59 minutes


31 minutes to 59 minutes, initial encounter


of 136

31 minutes to 59 minutes, subsequent

encounter


31 minutes to 59 minutes, sequela

850.2 Concussion with moderate

loss of consciousness

S06.0X3A Concussion with loss of consciousness of 1

hour to 5 hours 59 minutes, initial

encounter

S06.0X4A Concussion with loss of consciousness of 6

hours to 24 hours, initial encounter

850.3 Concussion with prolonged

loss of consciousness and

return to pre-existing

conscious level

S06.0X5A Concussion with loss of consciousness

greater than 24 hours with return to pre-

existing conscious level, initial encounter

850.4 Concussion with prolonged

loss of consciousness,

without return to pre-

existing conscious level

S06.0X6A Concussion with loss of consciousness

greater than 24 hours without return to pre-

existing conscious level with patient

surviving, initial encounter

850.5 Concussion with loss of

consciousness of

unspecified duration


any duration with death due to brain injury

prior to regaining consciousness, initial

encounter


any duration with death due to other cause


encounter


unspecified duration, initial encounter


unspecified duration, subsequent

encounter


unspecified duration, sequela

850.9 Concussion, unspecified S06.0X9A Concussion with loss of consciousness of




encounter



851.00 Cortex (cerebral)

contusion without mention

of open intracranial wound,

unspecified state of

consciousness

S06.330A Contusion and laceration of cerebrum,

unspecified, without loss of consciousness,

initial encounter



S06.310A Contusion and laceration of right cerebrum

without loss of consciousness, initial

of 136


with no loss of

consciousness

encounter

S06.310D Contusion and laceration of right cerebrum

without loss of consciousness, subsequent

encounter

S06.310S Contusion and laceration of right cerebrum

without loss of consciousness, sequela

S06.320A Contusion and laceration of left cerebrum


encounter

S06.320D Contusion and laceration of left cerebrum


encounter

S06.320S Contusion and laceration of left cerebrum




initial encounter

S06.330D Contusion and laceration of cerebrum,


subsequent encounter

S06.330S Contusion and laceration of cerebrum,


sequela




with brief [less than one

hour] loss of

consciousness


with loss of consciousness of 30 minutes or

less, initial encounter



less, subsequent encounter



less, sequela









less, sequela

of 136


unspecified, with loss of consciousness of











with moderate [1-24 hours]



with loss of consciousness of 1 hour to 5

hours 59 minutes, initial encounter



hours 59 minutes, subsequent encounter


with loss of consciousness of 6 hours to 24

hours, initial encounter



hours, subsequent encounter



hours, sequela









hours, sequela



6 hours to 24 hours, initial encounter



6 hours to 24 hours, subsequent encounter



6 hours to 24 hours, sequela




with loss of consciousness greater than 24

of 136


with prolonged [more than

24 hours] loss of

consciousness and return

to pre-existing conscious

level

hours with return to pre-existing conscious

level, initial encounter




level, subsequent encounter




level, sequela












level, sequela


unspecified, with loss of consciousness






existing conscious level, subsequent

encounter




existing conscious level, sequela





24 hours] loss of

consciousness without




hours without return to pre-existing

conscious level with patient surviving, initial

encounter

of 136

conscious level




conscious level with patient surviving,






sequela





encounter










sequela










surviving, subsequent encounter





surviving, sequela




with loss of consciousness

of unspecified duration


with loss of consciousness of unspecified

duration, initial encounter

of 136



duration, subsequent encounter



duration, sequela





sequela







with concussion,

unspecified









duration, sequela









duration, sequela



initial encounter







encounter



of 136



contusion with open

intracranial wound,


consciousness



initial encounter

S01.90xA Unspecified open wound of unspecified

part of head, initial encounter


contusion with open

intracranial wound, with no




initial encounter




contusion with open

intracranial wound, with

brief [less than one hour]








contusion with open


moderate [1-24 hours] loss

of consciousness







contusion with open


prolonged [more than 24

hours] loss of



level








contusion with open



hours] loss of



conscious level





encounter

of 136














encounter




contusion with open


loss of consciousness of








contusion with open


concussion, unspecified



initial encounter









laceration without mention



consciousness



encounter



encounter





of 136

encounter



encounter





initial encounter






sequela




with no loss of

consciousness



encounter



encounter





encounter



encounter





initial encounter






sequela




851.22 Cortex (cerebral) S06.311A Contusion and laceration of right cerebrum

of 136




hour] loss of

consciousness








less, sequela









less, sequela























hours, sequela







of 136



hours, sequela














24 hours] loss of



level












level, sequela





encounter










sequela




of 136









level, sequela





encounter










sequela









encounter














of 136






surviving, sequela





24 hours] loss of



conscious level





encounter










sequela





encounter










sequela








of 136








surviving, sequela














duration, sequela


with loss of consciousness of any duration

with death due to brain injury prior to

regaining consciousness, initial encounter




regaining consciousness, subsequent

encounter




regaining consciousness, sequela









duration, sequela








of 136


with concussion,

unspecified

encounter



encounter





encounter



encounter





initial encounter






sequela


laceration with open

intracranial wound,


consciousness



initial encounter









initial encounter













851.33 Cortex (cerebral) S06.334A Contusion and laceration of cerebrum,

of 136




of consciousness









hours] loss of



level











hours] loss of



conscious level












encounter







encounter












of 136













initial encounter



851.40 Cerebellar or brain stem




consciousness

S06.370A Contusion, laceration, and hemorrhage of

cerebellum without loss of consciousness,

initial encounter


brainstem without loss of consciousness,

initial encounter




with no loss of

consciousness



initial encounter



initial encounter





hour] loss of

consciousness


cerebellum with loss of consciousness of



brainstem with loss of consciousness of 30

minutes or less, initial encounter







cerebellum with loss of consciousness of 6





851.44 Cerebellar or brain stem S06.375A Contusion, laceration, and hemorrhage of

of 136




24 hours] loss



level

cerebellum with loss of consciousness




brainstem with loss of consciousness







24 hours] loss of



conscious level












brainstem with loss of consciousness of



encounter















with concussion,

unspecified



initial encounter




of 136


contusion with open

intracranial wound,


consciousness



initial encounter





initial encounter




contusion with open





initial encounter





initial encounter




contusion with open
















minutes to 59 minutes, initial encounter




contusion with open



of consciousness





of 136










encounter




contusion with open



hours] loss of



level














contusion with open



hours] loss of



conscious level





encounter











of 136




encounter







encounter














encounter




contusion with open















contusion with open









of 136


initial encounter





initial encounter












consciousness



initial encounter



initial encounter




with no loss of

consciousness



initial encounter



initial encounter




with brief [less than 1 hour]


















of 136












24 hours] loss of



level













24 hours] loss of



conscious level

























with concussion,

unspecified






of 136




intracranial wound,


consciousness



initial encounter





initial encounter









initial encounter





initial encounter



























of consciousness




encounter

of 136

















hours] loss of



level

















hours] loss of



conscious level





encounter











of 136




encounter







encounter































initial encounter











of 136





initial encounter



851.80 Other and unspecified

cerebral laceration and

contusion, without mention



consciousness



initial encounter






sequela





with no loss of

consciousness



encounter



encounter





encounter



encounter





initial encounter






of 136

sequela






hour] loss of

consciousness









less, sequela


with loss of consciousness of 31 minutes to

59 minutes, initial encounter



59 minutes, subsequent encounter



59 minutes, sequela









less, sequela









59 minutes, sequela






of 136











encounter


















hours, sequela






hours 59 minutes, initial encounter









hours, sequela



1 hour to 5 hours 59 minutes, subsequent

encounter


of 136














24 hours] loss of


to pre- existing conscious

level












level, sequela












level, sequela









encounter

of 136










24 hours] loss of



conscious level





encounter





sequela





encounter










sequela

















of 136



encounter










sequela











with concussion,

unspecified



with death due to other cause prior to










duration, sequela









duration, sequela



initial encounter

of 136






contusion, with open

intracranial wound,


consciousness



initial encounter










initial encounter
























of consciousness











hours] loss of






of 136


level








hours] loss of



conscious level





encounter







encounter

































of 136

initial encounter



852.00 Subarachnoid hemorrhage

following injury without

mention of open

intracranial wound,


consciousness

S06.6X0A Traumatic subarachnoid hemorrhage


encounter



mention of open





encounter

S06.6X9D Traumatic subarachnoid hemorrhage with

loss of consciousness of unspecified




mention of open




S06.6X1A Traumatic subarachnoid hemorrhage with

loss of consciousness of 30 minutes or






loss of consciousness of 31 minutes to 59

minutes, initial encounter


loss of consciousness of 1 hour to 5 hours




mention of open



of consciousness





loss of consciousness of 6 hours to 24




mention of open




loss of consciousness greater than 24



of 136

hours] loss of



level





encounter



mention of open



hours] loss of



conscious level









encounter



mention of open










S06.6X9S Traumatic subarachnoid hemorrhage with


duration, sequela



mention of open





encounter


following injury with open

intracranial wound,


consciousness



encounter

852.11 Subarachnoid hemorrhage S06.6X0A Traumatic subarachnoid hemorrhage

of 136





encounter






















of consciousness










hours) loss of



level











hours] loss of



conscious level


loss of consciousness of any duration with

death due to other cause prior to regaining

consciousness, initial encounter





of 136



encounter



















encounter



852.20 Subdural hemorrhage


mention of open

intracranial wound,


consciousness

S06.5X0A Traumatic subdural hemorrhage without

loss of consciousness, initial encounter



mention of open







mention of open




S06.5X1A Traumatic subdural hemorrhage with loss

of consciousness of 30 minutes or less,

initial encounter

S06.5X1D Traumatic subdural hemorrhage with loss



S06.5X1S Traumatic subdural hemorrhage with loss


sequela


of consciousness of 31 minutes to 59




of 136

minutes, subsequent encounter



minutes, sequela



mention of open



of consciousness



sequela


of consciousness of 6 hours to 24 hours,

initial encounter






sequela



mention of open



hours] loss of



level


of consciousness greater than 24 hours

with return to pre-existing conscious level,

initial encounter



without return to pre-existing conscious

level with patient surviving, initial encounter



mention of open



hours] loss of



conscious level




initial encounter






of 136



level with patient surviving, subsequent

encounter



mention of open





of consciousness of unspecified duration,

initial encounter






sequela



mention of open





S06.5X0D Traumatic subdural hemorrhage without

loss of consciousness, subsequent

encounter

S06.5X0S Traumatic subdural hemorrhage without

loss of consciousness, sequela



intracranial wound,


consciousness























of 136



initial encounter







of consciousness



initial encounter







hours] loss of



level




initial encounter







hours] loss of



conscious level








of consciousness of any duration with

death due to other cause before regaining











initial encounter



of 136







initial encounter







852.40 Extradural hemorrhage


mention of open

intracranial wound,


consciousness

S06.4X0D Epidural hemorrhage without loss of

consciousness, subsequent encounter

S06.4X0S Epidural hemorrhage without loss of

consciousness, sequela



mention of open



S06.4X0A Epidural hemorrhage without loss of


S06.4X0D Epidural hemorrhage without loss of






mention of open


brief [less than 1 hour] loss

of consciousness

S06.4X1A Epidural hemorrhage with loss of

consciousness of 30 minutes or less, initial

encounter

S06.4X1D Epidural hemorrhage with loss of

consciousness of 30 minutes or less,


S06.4X1S Epidural hemorrhage with loss of


sequela


consciousness of 31 minutes to 59






of 136


minutes, sequela



mention of open



of consciousness


consciousness of 6 hours to 24 hours,

initial encounter






sequela



mention of open



hours] loss of



level


consciousness greater than 24 hours with

return to pre-existing conscious level, initial

encounter



return to pre-existing conscious level,





sequela



mention of open



hours] loss of



conscious level




encounter







of 136


sequela


consciousness greater than 24 hours







encounter




level with patient surviving, sequela





encounter



mention of open





consciousness of any duration with death

due to other causes prior to regaining



consciousness of unspecified duration,

initial encounter






sequela



mention of open







initial encounter




of 136



intracranial wound,


consciousness

























encounter







of consciousness


consciousness of 1 hour to 5 hours 59






initial encounter







hours] loss of



level




encounter


of 136






hours] loss of



conscious level




















initial encounter














mention of open

intracranial wound,


consciousness

S06.340A Traumatic hemorrhage of right cerebrum


encounter

S06.340D Traumatic hemorrhage of right cerebrum


encounter

S06.340S Traumatic hemorrhage of right cerebrum


S06.350A Traumatic hemorrhage of left cerebrum


encounter

S06.350S Traumatic hemorrhage of left cerebrum

of 136





S06.359D Traumatic hemorrhage of left cerebrum





duration, sequela

S06.360A Traumatic hemorrhage of cerebrum,


initial encounter

S06.360D Traumatic hemorrhage of cerebrum,



S06.360S Traumatic hemorrhage of cerebrum,


sequela





encounter






mention of open





encounter



encounter





encounter





initial encounter


of 136





sequela





encounter






mention of open












less, sequela









59 minutes, sequela









less, sequela




of 136






59 minutes, sequela
















encounter






initial encounter







mention of open



of consciousness









hours, sequela



of 136







hours, sequela












initial encounter






sequela




mention of open



hours] loss of


to pre- existing conscious

level












level, sequela




of 136









level, sequela









encounter












sequela





encounter




mention of open



hours] loss of



conscious level





encounter


of 136









sequela





encounter










sequela















surviving, sequela




prior to regaining consciousness,




of 136


prior to regaining consciousness, sequela





encounter




mention of open












duration, sequela










encounter







mention of open





initial encounter







intracranial wound,



initial encounter

of 136


consciousness










initial encounter
























of consciousness











hours] loss of



level













of 136



hours] loss of



conscious level









encounter





















initial encounter



854.00 Intracranial injury of other

and unspecified nature

without mention of open

intracranial wound,


consciousness

S06.890A Other specified intracranial injury without


S06.890D Other specified intracranial injury without


encounter

S06.890S Other specified intracranial injury without


S06.9X0A Unspecified intracranial injury without loss

of consciousness, initial encounter

S06.9X0D Unspecified intracranial injury without loss

of consciousness, subsequent encounter

S06.9X0S Unspecified intracranial injury without loss

of 136

of consciousness, sequela






S06.1X0A Traumatic cerebral edema without loss of


S06.2X0A Diffuse traumatic brain injury without loss of


S06.300A Unspecified focal traumatic brain injury


encounter

S06.810A Injury of right internal carotid artery,

intracranial portion, not elsewhere

classified without loss of consciousness,

initial encounter

S06.820A Injury of left internal carotid artery,


classified without loss of consciousness,

initial encounter



S06.890D Other specified intracranial injury without


encounter

S06.890S Other specified intracranial injury without


S06.9X0A Unspecified intracranial injury without loss

of consciousness, initial encounter

S06.9X0D Unspecified intracranial injury without loss

of consciousness, subsequent encounter

S06.9X0S Unspecified intracranial injury without loss

of consciousness, sequela







S06.1X1A Traumatic cerebral edema with loss of


encounter




S06.2X1A Diffuse traumatic brain injury with loss of


encounter



of 136


S06.301A Unspecified focal traumatic brain injury with









S06.371D Contusion, laceration, and hemorrhage of



S06.371S Contusion, laceration, and hemorrhage of









encounter






classified with loss of consciousness of 30














S06.891A Other specified intracranial injury with loss


initial encounter

of 136

S06.891D Other specified intracranial injury with loss



S06.891S Other specified intracranial injury with loss


sequela









minutes, sequela

S06.9X1A Unspecified intracranial injury with loss of


encounter

S06.9X1D Unspecified intracranial injury with loss of



S06.9X1S Unspecified intracranial injury with loss of


sequela









minutes, sequela






of consciousness



initial encounter



initial encounter




of 136






hours to 24 hours, subsequent encounter



hours to 24 hours, sequela











initial encounter






sequela



initial encounter






sequela






hours] loss of



level




encounter



of 136

return to pre-existing conscious levels,

initial encounter





S06.305D Unspecified focal traumatic brain injury with




S06.305S Unspecified focal traumatic brain injury with



level, sequela







classified with loss of consciousness











initial encounter








sequela




encounter

of 136






hours] loss of



conscious level













encounter

S06.306D Unspecified focal traumatic brain injury with









sequela



















of 136



encounter













encounter













initial encounter



initial encounter






classified with loss of consciousness of








initial encounter




of 136



sequela



initial encounter






sequela








S06.0X0A Concussion without loss of consciousness,

initial encounter



with open intracranial

wound, unspecified state

of consciousness








wound, with no loss of

consciousness








wound, with brief [less

than one hour] loss of

consciousness








initial encounter



of 136




wound, with moderate [1-

24 hours] loss of

consciousness



initial encounter






wound, with prolonged

[more than 24 hours] loss

of consciousness and


conscious level




initial encounter






wound, with prolonged

[more than 24 hours] loss

of consciousness without


conscious level
















wound, with loss of

consciousness of




initial encounter






wound, with concussion,



initial encounter

of 136

unspecified







906.0 Late effect of open wound

of head, neck, and trunk

S01.00xS Unspecified open wound of scalp, sequela

S01.01xS Laceration without foreign body of scalp,

sequela

S01.02xS Laceration with foreign body of scalp,

sequela

S01.03xS Puncture wound without foreign body of

scalp, sequela

S01.04xS Puncture wound with foreign body of scalp,

sequela

S01.05xS Open bite of scalp, sequela

S01.101S Unspecified open wound of right eyelid and

periocular area, sequela

S01.102S Unspecified open wound of left eyelid and


S01.109S Unspecified open wound of unspecified

eyelid and periocular area, sequela

S01.111S Laceration without foreign body of right


S01.112S Laceration without foreign body of left


S01.119S Laceration without foreign body of

unspecified eyelid and periocular area,

sequela

S01.121S Laceration with foreign body of right eyelid

and periocular area, sequela

S01.122S Laceration with foreign body of left eyelid

and periocular area, sequela

S01.129S Laceration with foreign body of unspecified


S01.131S Puncture wound without foreign body of

right eyelid and periocular area, sequela

S01.132S Puncture wound without foreign body of left




sequela

S01.141S Puncture wound with foreign body of right


of 136

S01.142S Puncture wound with foreign body of left


S01.149S Puncture wound with foreign body of


sequela

S01.151S Open bite of right eyelid and periocular

area, sequela

S01.152S Open bite of left eyelid and periocular area,

sequela

S01.159S Open bite of unspecified eyelid and


S01.20xS Unspecified open wound of nose, sequela

S01.21xS Laceration without foreign body of nose,

sequela

S01.22xS Laceration with foreign body of nose,

sequela


nose, sequela

S01.24xS Puncture wound with foreign body of nose,

sequela

S01.25xS Open bite of nose, sequela

S01.301S Unspecified open wound of right ear,

sequela

S01.302S Unspecified open wound of left ear,

sequela


ear, sequela

S01.311S Laceration without foreign body of right ear,

sequela

S01.312S Laceration without foreign body of left ear,

sequela


unspecified ear, sequela

S01.321S Laceration with foreign body of right ear,

sequela

S01.322S Laceration with foreign body of left ear,

sequela


ear, sequela


right ear, sequela


ear, sequela




of 136

ear, sequela


ear, sequela



S01.351S Open bite of right ear, sequela

S01.352S Open bite of left ear, sequela

S01.359S Open bite of unspecified ear, sequela

S01.401S Unspecified open wound of right cheek and

temporomandibular area, sequela

S01.402S Unspecified open wound of left cheek and



cheek and temporomandibular area,

sequela



sequela



sequela


unspecified cheek and temporomandibular

area, sequela

S01.421S Laceration with foreign body of right cheek

and temporomandibular area, sequela

S01.422S Laceration with foreign body of left cheek

and temporomandibular area, sequela



sequela


right cheek and temporomandibular area,

sequela



sequela



area, sequela



sequela



sequela

of 136



area, sequela

S01.451S Open bite of right cheek and


S01.452S Open bite of left cheek and


S01.459S Open bite of unspecified cheek and


S01.501S Unspecified open wound of lip, sequela

S01.502S Unspecified open wound of oral cavity,

sequela

S01.511S Laceration without foreign body of lip,

sequela

S01.512S Laceration without foreign body of oral

cavity, sequela

S01.521S Laceration with foreign body of lip, sequela

S01.522S Laceration with foreign body of oral cavity,

sequela

S01.531S Puncture wound without foreign body of lip,

sequela


oral cavity, sequela

S01.541S Puncture wound with foreign body of lip,

sequela

S01.542S Puncture wound with foreign body of oral

cavity, sequela

S01.551S Open bite of lip, sequela

S01.552S Open bite of oral cavity, sequela

S01.80xS Unspecified open wound of other part of

head, sequela

S01.81xS Laceration without foreign body of other

part of head, sequela

S01.82xS Laceration with foreign body of other part of

head, sequela


other part of head, sequela

S01.84xS Puncture wound with foreign body of other


S01.85xS Open bite of other part of head, sequela

S01.90xS Unspecified open wound of unspecified


S01.91xS Laceration without foreign body of

unspecified part of head, sequela

S01.92xS Laceration with foreign body of unspecified

of 136




S01.94xS Puncture wound with foreign body of


S01.95xS Open bite of unspecified part of head,

sequela

S03.2xxS Dislocation of tooth, sequela

S05.20xS Ocular laceration and rupture with prolapse

or loss of intraocular tissue, unspecified

eye, sequela


or loss of intraocular tissue, right eye,

sequela


or loss of intraocular tissue, left eye,

sequela

S05.30xS Ocular laceration without prolapse or loss

of intraocular tissue, unspecified eye,

sequela


of intraocular tissue, right eye, sequela


of intraocular tissue, left eye, sequela

S05.40xS Penetrating wound of orbit with or without

foreign body, unspecified eye, sequela


foreign body, right eye, sequela


foreign body, left eye, sequela

S05.50xS Penetrating wound with foreign body of

unspecified eyeball, sequela

S05.51xS Penetrating wound with foreign body of

right eyeball, sequela

S05.52xS Penetrating wound with foreign body of left

eyeball, sequela

S05.60xS Penetrating wound without foreign body of

unspecified eyeball, sequela


right eyeball, sequela


left eyeball, sequela

S08.0xxS Avulsion of scalp, sequela

S08.111S Complete traumatic amputation of right ear,

sequela

S08.112S Complete traumatic amputation of left ear,

of 136

sequela

S08.119S Complete traumatic amputation of


S08.121S Partial traumatic amputation of right ear,

sequela

S08.122S Partial traumatic amputation of left ear,

sequela

S08.129S Partial traumatic amputation of unspecified

ear, sequela

S08.811S Complete traumatic amputation of nose,

sequela

S08.812S Partial traumatic amputation of nose,

sequela

S08.89xS Traumatic amputation of other parts of

head, sequela

S09.12xS Laceration of muscle and tendon of head,

sequela

S09.21xS Traumatic rupture of right ear drum,

sequela

S09.22xS Traumatic rupture of left ear drum, sequela

S09.311S Primary blast injury of right ear, sequela

S09.312S Primary blast injury of left ear, sequela

S09.313S Primary blast injury of ear, bilateral,

sequela

S09.319S Primary blast injury of unspecified ear,

sequela

S11.011S Laceration without foreign body of larynx,

sequela

S11.012S Laceration with foreign body of larynx,

sequela


larynx, sequela

S11.014S Puncture wound with foreign body of larynx,

sequela

S11.015S Open bite of larynx, sequela

S11.019S Unspecified open wound of larynx, sequela

S11.021S Laceration without foreign body of trachea,

sequela

S11.022S Laceration with foreign body of trachea,

sequela


trachea, sequela


trachea, sequela

S11.029S Unspecified open wound of trachea,

sequela

of 136

S11.031S Laceration without foreign body of vocal

cord, sequela

S11.032S Laceration with foreign body of vocal cord,

sequela


vocal cord, sequela

S11.034S Puncture wound with foreign body of vocal

cord, sequela

S11.039S Unspecified open wound of vocal cord,

sequela

S11.10xS Unspecified open wound of thyroid gland,

sequela

S11.11xS Laceration without foreign body of thyroid

gland, sequela

S11.12xS Laceration with foreign body of thyroid

gland, sequela


thyroid gland, sequela


thyroid gland, sequela

S11.20xS Unspecified open wound of pharynx and

cervical esophagus, sequela

S11.21xS Laceration without foreign body of pharynx

and cervical esophagus, sequela

S11.22xS Laceration with foreign body of pharynx and

cervical esophagus, sequela


pharynx and cervical esophagus, sequela


pharynx and cervical esophagus, sequela

S11.25xS Open bite of pharynx and cervical

esophagus, sequela

S11.80xS Unspecified open wound of other specified

part of neck, sequela

S11.81xS Laceration without foreign body of other

specified part of neck, sequela

S11.82xS Laceration with foreign body of other



other specified part of neck, sequela

S11.84xS Puncture wound with foreign body of other


S11.89xS Other open wound of other specified part of

neck, sequela

S11.90xS Unspecified open wound of unspecified


of 136


unspecified part of neck, sequela







S16.2xxS Laceration of muscle, fascia and tendon at

neck level, sequela

S21.001S Unspecified open wound of right breast,

sequela

S21.002S Unspecified open wound of left breast,

sequela


breast, sequela


breast, sequela


breast, sequela


unspecified breast, sequela

S21.021S Laceration with foreign body of right breast,

sequela

S21.022S Laceration with foreign body of left breast,

sequela


breast, sequela


right breast, sequela


breast, sequela




breast, sequela


breast, sequela



S21.051S Open bite of right breast, sequela

S21.052S Open bite of left breast, sequela

S21.059S Open bite of unspecified breast, sequela

S21.101S Unspecified open wound of right front wall

of thorax without penetration into thoracic

cavity, sequela

of 136

S21.102S Unspecified open wound of left front wall of

thorax without penetration into thoracic

cavity, sequela


front wall of thorax without penetration into

thoracic cavity, sequela




S21.112S Laceration without foreign body of left front

wall of thorax without penetration into



unspecified front wall of thorax without

penetration into thoracic cavity, sequela

S21.121S Laceration with foreign body of right front



S21.122S Laceration with foreign body of left front













unspecified front wall of thorax without


S21.201S Unspecified open wound of right back wall

of thorax without penetration into thoracic

cavity, sequela

S21.202S Unspecified open wound of left back wall of

thorax without penetration into thoracic

cavity, sequela


back wall of thorax without penetration into





S21.212S Laceration without foreign body of left back

of 136




unspecified back wall of thorax without


S21.221S Laceration with foreign body of right back



S21.222S Laceration with foreign body of left back













unspecified back wall of thorax without


S21.301S Unspecified open wound of right front wall

of thorax with penetration into thoracic

cavity, sequela

S21.302S Unspecified open wound of left front wall of

thorax with penetration into thoracic cavity,

sequela


front wall of thorax with penetration into





S21.312S Laceration without foreign body of left front

wall of thorax with penetration into thoracic

cavity, sequela


unspecified front wall of thorax with


S21.321S Laceration with foreign body of right front


cavity, sequela

S21.322S Laceration with foreign body of left front


of 136

cavity, sequela





right front wall of thorax with penetration

into thoracic cavity, sequela
















S21.351S Open bite of right front wall of thorax with


S21.352S Open bite of left front wall of thorax with


S21.359S Open bite of unspecified front wall of thorax

with penetration into thoracic cavity,

sequela

S21.401S Unspecified open wound of right back wall

of thorax with penetration into thoracic

cavity, sequela

S21.402S Unspecified open wound of left back wall of


sequela


back wall of thorax with penetration into





S21.412S Laceration without foreign body of left back


cavity, sequela


unspecified back wall of thorax with

of 136


S21.421S Laceration with foreign body of right back


cavity, sequela

S21.422S Laceration with foreign body of left back


cavity, sequela





right back wall of thorax with penetration

into thoracic cavity, sequela
















S21.451S Open bite of right back wall of thorax with


S21.452S Open bite of left back wall of thorax with


S21.459S Open bite of unspecified back wall of


sequela


unspecified part of thorax, sequela


part of thorax, sequela





S21.95xS Open bite of unspecified part of thorax,

sequela

S28.1xxS Traumatic amputation (partial) of part of

of 136

thorax, except breast, sequela

S28.211S Complete traumatic amputation of right

breast, sequela

S28.212S Complete traumatic amputation of left

breast, sequela

S28.219S Complete traumatic amputation of


S28.221S Partial traumatic amputation of right breast,

sequela

S28.222S Partial traumatic amputation of left breast,

sequela

S28.229S Partial traumatic amputation of unspecified

breast, sequela

S29.021S Laceration of muscle and tendon of front

wall of thorax, sequela

S29.022S Laceration of muscle and tendon of back

wall of thorax, sequela

S29.029S Laceration of muscle and tendon of

unspecified wall of thorax, sequela

S31.001S Unspecified open wound of lower back and

pelvis with penetration into

retroperitoneum, sequela

S31.010S Laceration without foreign body of lower

back and pelvis without penetration into


S31.011S Laceration without foreign body of lower

back and pelvis with penetration into


S31.020S Laceration with foreign body of lower back

and pelvis without penetration into


S31.021S Laceration with foreign body of lower back

and pelvis with penetration into



lower back and pelvis without penetration

into retroperitoneum, sequela


lower back and pelvis with penetration into


S31.040S Puncture wound with foreign body of lower

back and pelvis without penetration into


S31.041S Puncture wound with foreign body of lower

back and pelvis with penetration into


of 136

S31.050S Open bite of lower back and pelvis without

penetration into retroperitoneum, sequela

S31.051S Open bite of lower back and pelvis with

penetration into retroperitoneum, sequela

S31.100S Unspecified open wound of abdominal wall,

right upper quadrant without penetration

into peritoneal cavity, sequela


left upper quadrant without penetration into

peritoneal cavity, sequela


epigastric region without penetration into



right lower quadrant without penetration



left lower quadrant without penetration into



periumbilic region without penetration into



abdominal wall, right upper quadrant

without penetration into peritoneal cavity,

sequela


abdominal wall, left upper quadrant without

penetration into peritoneal cavity, sequela


abdominal wall, epigastric region without



abdominal wall, right lower quadrant


sequela


abdominal wall, left lower quadrant without



abdominal wall, periumbilic region without



abdominal wall, unspecified quadrant


sequela

of 136

S31.120S Laceration of abdominal wall with foreign

body, right upper quadrant without



body, left upper quadrant without



body, epigastric region without penetration



body, right lower quadrant without



body, left lower quadrant without



body, periumbilic region without penetration



body, unspecified quadrant without


S31.130S Puncture wound of abdominal wall without

foreign body, right upper quadrant without



foreign body, left upper quadrant without



foreign body, epigastric region without



foreign body, right lower quadrant without



foreign body, left lower quadrant without



foreign body, periumbilic region without



foreign body, unspecified quadrant without


S31.140S Puncture wound of abdominal wall with

foreign body, right upper quadrant without



of 136

foreign body, left upper quadrant without



foreign body, epigastric region without



foreign body, right lower quadrant without



foreign body, left lower quadrant without



foreign body, periumbilic region without



foreign body, unspecified quadrant without


S31.150S Open bite of abdominal wall, right upper

quadrant without penetration into peritoneal

cavity, sequela

S31.151S Open bite of abdominal wall, left upper


cavity, sequela

S31.152S Open bite of abdominal wall, epigastric

region without penetration into peritoneal

cavity, sequela

S31.153S Open bite of abdominal wall, right lower


cavity, sequela

S31.154S Open bite of abdominal wall, left lower


cavity, sequela

S31.155S Open bite of abdominal wall, periumbilic

region without penetration into peritoneal

cavity, sequela

S31.159S Open bite of abdominal wall, unspecified


cavity, sequela

S31.20xS Unspecified open wound of penis, sequela

S31.21xS Laceration without foreign body of penis,

sequela

S31.22xS Laceration with foreign body of penis,

sequela


penis, sequela

S31.24xS Puncture wound with foreign body of penis,

of 136

sequela

S31.25xS Open bite of penis, sequela

S31.30xS Unspecified open wound of scrotum and

testes, sequela

S31.31xS Laceration without foreign body of scrotum

and testes, sequela

S31.32xS Laceration with foreign body of scrotum

and testes, sequela


scrotum and testes, sequela


scrotum and testes, sequela

S31.35xS Open bite of scrotum and testes, sequela

S31.40xS Unspecified open wound of vagina and

vulva, sequela

S31.41xS Laceration without foreign body of vagina

and vulva, sequela

S31.42xS Laceration with foreign body of vagina and

vulva, sequela


vagina and vulva, sequela

S31.44xS Puncture wound with foreign body of vagina

and vulva, sequela

S31.45xS Open bite of vagina and vulva, sequela


right upper quadrant with penetration into



left upper quadrant with penetration into



epigastric region with penetration into



right lower quadrant with penetration into



left lower quadrant with penetration into



periumbilic region with penetration into



unspecified quadrant with penetration into


of 136


abdominal wall, right upper quadrant with



abdominal wall, left upper quadrant with



abdominal wall, epigastric region with



abdominal wall, right lower quadrant with



abdominal wall, left lower quadrant with



abdominal wall, periumbilic region with



abdominal wall, unspecified quadrant with


S31.620S Laceration with foreign body of abdominal

wall, right upper quadrant with penetration



wall, left upper quadrant with penetration



wall, epigastric region with penetration into



wall, right lower quadrant with penetration



wall, left lower quadrant with penetration



wall, periumbilic region with penetration into



wall, unspecified quadrant with penetration






of 136







































S31.650S Open bite of abdominal wall, right upper

quadrant with penetration into peritoneal

cavity, sequela

S31.651S Open bite of abdominal wall, left upper


cavity, sequela

S31.652S Open bite of abdominal wall, epigastric

region with penetration into peritoneal

of 136

cavity, sequela

S31.653S Open bite of abdominal wall, right lower


cavity, sequela

S31.654S Open bite of abdominal wall, left lower


cavity, sequela

S31.655S Open bite of abdominal wall, periumbilic

region with penetration into peritoneal

cavity, sequela

S31.659S Open bite of abdominal wall, unspecified


cavity, sequela


unspecified buttock, sequela


buttock, sequela





S31.805S Open bite of unspecified buttock, sequela


buttock, sequela


buttock, sequela

S31.812S Laceration with foreign body of right

buttock, sequela


right buttock, sequela


buttock, sequela

S31.815S Open bite of right buttock, sequela

S31.819S Unspecified open wound of right buttock,

sequela


buttock, sequela

S31.822S Laceration with foreign body of left buttock,

sequela


buttock, sequela


buttock, sequela

S31.825S Open bite of left buttock, sequela

S31.829S Unspecified open wound of left buttock,

sequela

of 136

S31.831S Laceration without foreign body of anus,

sequela

S31.832S Laceration with foreign body of anus,

sequela


anus, sequela

S31.834S Puncture wound with foreign body of anus,

sequela

S31.835S Open bite of anus, sequela

S31.839S Unspecified open wound of anus, sequela

S38.211S Complete traumatic amputation of female

external genital organs, sequela

S38.212S Partial traumatic amputation of female

external genital organs, sequela

S38.221S Complete traumatic amputation of penis,

sequela

S38.222S Partial traumatic amputation of penis,

sequela

S38.231S Complete traumatic amputation of scrotum

and testis, sequela

S38.232S Partial traumatic amputation of scrotum

and testis, sequela

S38.3xxS Transection (partial) of abdomen, sequela

S39.021S Laceration of muscle, fascia and tendon of

abdomen, sequela


lower back, sequela


pelvis, sequela

907.0 Late effect of intracranial

injury without mention of

skull fracture

S06.0X0S Concussion without loss of consciousness,

sequela





S06.0X3S Concussion with loss of consciousness of 1

hour to 5 hours 59 minutes, sequela

S06.0X4S Concussion with loss of consciousness of 6


S06.0X5S Concussion with loss of consciousness



S06.0X6S Concussion with loss of consciousness



of 136

surviving, sequela









S06.1X0S Traumatic cerebral edema without loss of


S06.1X1S Traumatic cerebral edema with loss of


sequela



minutes, sequela



minutes, sequela



sequela




sequela







due to brain injury prior to regaining




due to other cause prior to regaining




sequela

S06.2X5S Diffuse traumatic brain injury with loss of


return to pre-existing conscious levels,

sequela

of 136















sequela



less, sequela



minutes, sequela



59 minutes, sequela



hours, sequela




level, sequela





sequela



death due to brain injury prior to regaining








of 136

duration, sequela



less, sequela



59 minutes, sequela



hours 59 minutes, sequela



hours, sequela




level, sequela





sequela











duration, sequela



less, sequela



59 minutes, sequela






hours, sequela


of 136



level, sequela





sequela











duration, sequela









1 hour to 5 hours 59 minutes, sequela












surviving, sequela







of 136








less, sequela



59 minutes, sequela






hours, sequela




level, sequela





sequela











duration, sequela



less, sequela



59 minutes, sequela




of 136



hours, sequela




level, sequela





sequela











duration, sequela









1 hours to 5 hours 59 minutes, sequela












surviving, sequela

of 136














sequela










sequela



minutes or less, sequela



minutes to 59 minutes, sequela















surviving, sequela

of 136





sequela



minutes, sequela



minutes, sequela



sequela




sequela

















sequela



minutes, sequela

S06.6X0S Traumatic subarachnoid hemorrhage






of 136



duration, sequela

S06.811S Injury of right internal carotid artery,


























surviving, sequela



classified with loss of consciousness of any

duration with death due to brain injury prior

to regaining consciousness, sequela




duration with death due to other cause prior






of 136

S06.821S Injury of left internal carotid artery,


























surviving, sequela




duration with death due to brain injury prior





duration with death due to other cause prior








sequela

of 136



minutes, sequela


of consciousness of 1 hour to 5 hours 59

minutes, sequela




sequela







death due to brain injury prior to regaining








sequela



sequela



minutes, sequela



minutes, sequela



sequela




sequela





of 136











sequela

V10.01 Personal history of

malignant neoplasm of

tongue

Z85.810 Personal history of malignant neoplasm of

tongue



other and unspecified oral

cavity and pharynx


other sites of lip, oral cavity, and pharynx


unspecified site of lip, oral cavity, and

pharynx



esophagus


esophagus



larynx


larynx

V43.81 Larynx replacement Z96.3 Presence of artificial larynx

Limitation According to those established in the policy. ___________ ____________________________________ Ángela Hernández, MD Benjamín Santiago MD Associate Medical Director Executive Medical Director Revisión: 06/22/2016

04/1/2015

08/19/2014 (ICD-10 added)

of 136

References

1. National Institutes of Health (NIH), National Institute on Deafness and Other Communication Disorders. Dysphagia. Health Information. NIH Document No. 99-4307. Bethesda, MD: NIH; October 1998. Available at: http://www.nidcd.nih.gov/health/voice/dysphagia.asp. Accessed May 13, 2002.

2. Medicare LCD : L29313

3. American Speech-Language Hearing Association (ASHA). Swallowing. Public Information. Rockville, MD: ASHA; 2002. Available at: http://www.asha.org/public/speech/swallowing/Swallowing-Disorders-in-Adults.htm. Accessed May 13, 2002.

4. Paik N. Dysphagia. eMedicine J. 2001;2(7). Available at: http://www.emedicine.com/pmr/topic194.htm. Accessed May 13, 2002.

5. Davies S. An interdisciplinary approach to the management of dysphagia. Prof Nurse. 2002;18(1):22-25.

6. Cook IJ, Kahrilas PJ. AGA technical review on management of oropharyngeal dysphagia. Gastroenterology. 1999;116(2):455-478

7. Aetna : Clinical Policy Bulletin :Dysphagia Therapy Number 0625

8. White, JV., Guenter, P., Jensen, G., Malone, Al, Schofield, M., the Academy Malnutrition Work Group, the A.S.P.E.N Malnutrition Task Force, & the A.S.P.E.N. Board of Director. Consensus Statement of The Academy of Nutrition and Dietetics / American Society for Parenteral and Enteral Nutrition: Characteristics Recommended for the Identification and Documentation of Adult Malnutrition (Undernutrition), Journal of The Academy of Nutrition and Dietetics. 2012; 112(5): 730-738.

http://www.emedicine.com/pmr/topic194.htm

8.01.34 therapy for dysphagia

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