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Speech-Language Pathology ICD-10-CM Code Changes for 2022

The following new and revised ICD-10-CM (International Classification of Diseases, 10th Revision, Clinical Modification) codes are effective October 1, 2021, for fiscal year (FY) 2022. ICD-10-CM codes are updated annually. For past updates, see speech-language pathology ICD-10-CM code changes for 2021 and 2020.

In FY 2022, speech-language pathologists (SLPs) will see new ICD-10-CM codes for pediatric feeding disorder and post COVID-19 conditions. SLPs should also be aware of new ICD-10 codes related to other specified diseases of the esophagus and cough.

Note: Always check with payers regarding coverage of new or revised ICD-10-CM codes. Coding changes may not always alter payer coverage decisions for specific conditions.

On this page:

Pediatric Feeding Disorder (PFD)

R63.3  Feeding difficulties (revised category, do not report on claim)

Excludes2: eating disorders (F50.-)
                    feeding problems of newborn (P92.-)
                     infant feeding disorder of nonorganic origin (F98.2-)

R63.30  Feeding difficulties, unspecified (new code)

R63.31  Pediatric feeding disorder, acute (new code)
                            Pediatric feeding dysfunction, acute

Code also, if applicable, associated conditions such as:

aspiration pneumonia (J69.0)
dysphagia (R13.1-)
gastro-esophageal reflux disease (K21.-)
malnutrition (E40-E46)

R63.32  Pediatric feeding disorder, chronic (new code)
              Pediatric feeding dysfunction, chronic

Code also, if applicable, associated conditions such as:

aspiration pneumonia (J69.0)
dysphagia (R13.1-)
gastro-esophageal reflux disease (K21.-)
malnutrition (E40-E46)

R63.39  Other feeding difficulties (new code)
              Feeding problem (elderly) (infant) NOS
              Picky eater

ASHA Notes

  • The new codes are based on the clinical concepts and definitions detailed in “Pediatric Feeding Disorder—Consensus Definition and Conceptual Framework.” For additional clinical considerations, see ASHA’s Practice Portal on Pediatric Feeding and Swallowing.
  • When reporting a PFD diagnosis, SLPs should document the duration of the condition to support the selection and/or to help billers/coders choose the appropriate code.
    • Acute PFD is defined as less than 3 months’ duration.
    • Chronic PFD is defined as 3 or more months’ duration.
  • The PFD codes allow members of interdisciplinary feeding teams, including SLPs, to integrate medical, nutritional, feeding skill, and/or psychosocial dysfunctions into a unified diagnosis.
  • SLPs should also report additional codes (e.g., malnutrition or dysphagia) to provide detail about the underlying medical cause of PFD, or the symptoms and conditions resulting from PFD.
    • For example, report one of the new PFD codes with a code from the R13.1- series when PFD and dysphagia co-occur.
    • The first listed code on the claim is typically the treating diagnosis, or the code that describes the primary reason for the visit. For additional guidance, see ASHA's Q&A on primary and secondary codes.
    • The code also instructions for R63.31 and R63.32 include examples of associated conditions. They are not exhaustive lists.
  • Keep in mind that payers may not cover treatment for issues such as food-texture sensitivity if there is no evidence of an oral-function impairment, regardless of the code changes.
  • The ICD-10-CM code changes do not affect existing procedure codes for swallowing and feeding clinical evaluation (92610) and treatment (92526).

Post COVID-19 Conditions

U09  Post COVID-19 condition (new category, do not report on claim)

U09.9  Post COVID-19 condition, unspecified (new code)
            Post-acute sequela of COVID-19

Note: This code enables establishment of a link with COVID-19. This code is not to be used in cases that are still presenting with active COVID-19. However, an exception is made in cases of re-infection with COVID-19, occurring with a condition related to prior COVID-19.

Code first the specific condition related to COVID-19 if known, such as:

chronic respiratory failure (J96.1-)
loss of smell (R43.8)
loss of taste (R43.8)
multisystem inflammatory syndrome (M35.81)
pulmonary embolism (I26.-)
pulmonary fibrosis (J84.10)

ASHA Notes

  • U09.9 describes patients with a confirmed case of COVID-19 but who are no longer infected (resolved COVID-19). Use this code when there is clear documentation that the speech, language, cognitive, voice, or swallowing disorder is directly caused by COVID-19.
    • Clinicians previously used B94.8 (sequelae of other specified infectious and parasitic diseases).
  • Report U09.9 secondary to the treating diagnosis code(s) (e.g., dysphagia).
  • Consult the medical record or referring physician before reporting U09.9 in addition to the treating diagnosis. For additional details, see FAQs Regarding ICD-10-CM Coding for COVID-19 (AHA).
  • There is no time limit on when personal history or sequelae codes may be used.
  • Additional ICD-10 codes describe other COVID-19 related cases, such as patients with a current or recurrent infection, or a personal history of COVID-19. See ASHA’s ICD-10-CM code list [PDF] and the 2021 update for more information.

Other Codes of Interest

SLPs may be interested in the following new codes. Consult the medical record or referring physician before reporting a medical diagnosis in addition to the treating diagnosis.

Other Specified Diseases of the Esophagus

K22.8  Other specified diseases of esophagus (revised category, do not report on claim)

K22.81  Esophageal polyp (new code)

Excludes1: benign neoplasm of esophagus (D13.0)

K22.82  Esophagogastric junction polyp (new code)

Excludes1: benign neoplasm of stomach (D13.1)

K22.89  Other specified disease of esophagus (new code)
             Hemorrhage of esophagus NOS

Cough

R05  Cough (revised category, do not report on claim)

Excludes1: cough with hemorrhage (R04.2)
                    paroxysmal cough due to Bordetella pertussis (A37.0-)

Excludes2: cough with hemorrhage (R04.2)

R05.1  Acute cough (new code)

R05.2  Subacute cough (new code)

R05.3  Chronic cough (new code)
            Persistent cough
            Refractory cough
            Unexplained cough

R05.4  Cough syncope (new code)

Code first syncope and collapse (R55)

R05.8  Other specified cough (new code)

R05.9  Cough, unspecified (new code)

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