Symptoms and signs involving speech and voice
ICD-10 Codes (15)
R48R48.0R48.1R48.2R48.3R48.8R48.9R49R49.0R49.1R49.2R49.21R49.22R49.8R49.9Updates & Changes
FY 2026 Updates
Deleted Codes
No codes deleted in this range for FY 2026
No significant changes for FY 2026
This range maintains stability with current coding practices
Historical Changes
- •FY 2025: Routine maintenance updates with minor terminology clarifications
- •FY 2024: Enhanced specificity requirements for certain code ranges
- •FY 2023: Updated documentation guidelines for improved clarity
Upcoming Changes
- •Proposed updates pending review by Coordination and Maintenance Committee
- •Under consideration: Enhanced digital health integration codes
Implementation Guidance
- •Review all FY 2026 updates for R47-R49 codes before implementation
- •Always verify the most current codes in the ICD-10-CM manual
- •Ensure clinical documentation supports the selected diagnosis codes
- +3 more guidance items...
Range Overview
The ICD-10 code range R47-R49 encompasses symptoms and signs involving speech and voice. This includes conditions such as dysphonia, aphasia, and speech disturbances. These codes are used to document symptoms related to speech and voice disorders when a definitive diagnosis has not been established.
Key Usage Points:
- •R47-R49 codes are used when a definitive diagnosis has not been established.
- •These codes cover a range of speech and voice symptoms, including dysphonia and aphasia.
- •Always code the underlying condition first, if known.
- •Use additional codes to identify any associated conditions.
- •Document the severity and duration of symptoms when possible.
Coding Guidelines
When to Use:
- ✓When a patient presents with speech or voice symptoms without a confirmed diagnosis.
- ✓When a patient has a known speech or voice disorder, but it is not the primary reason for the visit.
- ✓When a patient's speech or voice symptoms are chronic or recurring.
- ✓When a patient's speech or voice symptoms are causing significant distress or impairment.
When NOT to Use:
- ✗When a definitive diagnosis has been established.
- ✗When the speech or voice symptoms are transient or expected (e.g., hoarseness after attending a loud concert).
- ✗When the speech or voice symptoms are due to a condition coded elsewhere.
- ✗When the speech or voice symptoms are not significant or relevant to the current medical care.
Code Exclusions
Always verify exclusions in the ICD-10-CM manual or coding software.
Documentation Requirements
Documentation for R47-R49 codes should clearly describe the patient's speech or voice symptoms, their severity and duration, and any known or suspected underlying conditions. Any relevant clinical findings or test results should also be documented.
Clinical Information:
- •Description of the speech or voice symptoms
- •Severity and duration of symptoms
- •Known or suspected underlying conditions
- •Relevant clinical findings or test results
Supporting Evidence:
- •Patient self-report
- •Clinical observations
- •Results of speech or voice assessments
- •Medical history
Good Documentation Example:
Patient presents with chronic hoarseness and difficulty speaking loudly. Symptoms have been present for six months and are causing distress. No known underlying condition.
Poor Documentation Example:
Patient has voice problems.
Common Documentation Errors:
- ⚠Not documenting the severity or duration of symptoms
- ⚠Not documenting any known or suspected underlying conditions
- ⚠Not including relevant clinical findings or test results
Range Statistics
Coding Complexity
The complexity of coding R47-R49 codes is medium due to the need to determine the primary cause of the symptoms, identify any associated conditions, assess the severity and duration of symptoms, and navigate the exclusions for this code range.
Key Factors:
- ▸Determining the primary cause of the speech or voice symptoms
- ▸Identifying any associated conditions
- ▸Assessing the severity and duration of symptoms
- ▸Navigating the exclusions for this code range
Specialty Focus
R47-R49 codes are commonly used in otolaryngology, neurology, and speech-language pathology. These specialties often encounter patients with speech and voice symptoms.
Primary Specialties:
Clinical Scenarios:
- • A patient with Parkinson's disease presents with a soft, monotone voice.
- • A patient with a history of throat cancer has chronic hoarseness.
- • A patient presents with sudden speech difficulties after a stroke.
- • A patient with vocal cord nodules has a raspy voice.
- • A patient with anxiety presents with a shaky voice.
Resources & References
Resources for coding R47-R49 codes include the ICD-10-CM manual, coding software, and clinical reference materials. Educational materials on speech and voice disorders may also be helpful.
Official Guidelines:
- ICD-10-CM Official Guidelines for Coding and Reporting
- American Health Information Management Association (AHIMA) guidelines
- Centers for Medicare & Medicaid Services (CMS) guidelines
Clinical References:
- American Speech-Language-Hearing Association (ASHA) resources
- National Institute on Deafness and Other Communication Disorders (NIDCD) resources
Educational Materials:
- ICD-10-CM Coding Handbook
- Medical Coding Online for Step-by-Step Medical Coding
Frequently Asked Questions
Can R47-R49 codes be used as primary codes?
Yes, if the speech or voice symptoms are the primary reason for the visit and a definitive diagnosis has not been established.