R57-R59
Medium Complexity

Symptoms and signs involving speech and voice

Primary Specialty: Otolaryngology
Last Updated: 2025-09-10

ICD-10 Codes (5)

4 billable
0 category headers
R58
Billable
Hemorrhage, not elsewhere classified
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R59
Enlarged lymph nodes
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R59.0
Billable
Localized enlarged lymph nodes
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R59.1
Billable
Generalized enlarged lymph nodes
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R59.9
Billable
Enlarged lymph nodes, unspecified
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Updates & Changes

FY 2026 Updates

Current Year

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 R57-R59 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

high priority

The R57-R59 range in ICD-10 covers symptoms and signs involving speech and voice. These codes are used to document conditions like dysphonia (R49), aphonia (R49.0), dysarthria and anarthria (R47.1), and other speech disturbances (R47.8). This range is essential for capturing patient symptoms related to voice and speech that may not be linked to a specific disease but are significant for diagnosis and treatment.

Key Usage Points:

  • Use R49 codes for voice and resonance disorders, including dysphonia and aphonia.
  • R47.1 is used for dysarthria and anarthria, which are speech articulation disorders.
  • R47.8 covers other speech disturbances not classified elsewhere.
  • Always code to the highest level of specificity available.
  • Consider using additional codes to identify any associated underlying conditions.

Coding Guidelines

When to Use:

  • When a patient presents with hoarseness or voice change without a diagnosed cause.
  • When a patient has difficulty articulating speech due to a neurological condition.
  • When a patient exhibits stuttering or other speech disturbances.
  • When documenting post-procedural speech or voice complications.
  • When a patient's speech or voice symptom is significant but the underlying condition is unknown.

When NOT to Use:

  • When the speech or voice symptom is minor and not affecting the patient's health.
  • When the symptom has a specific diagnosis that should be coded instead.
  • When the symptom is a normal side effect of a medication or treatment.
  • When the symptom is expected in the patient's condition and does not require additional intervention.

Code Exclusions

Always verify exclusions with the latest ICD-10-CM official guidelines and updates.

Documentation Requirements

For R57-R59 codes, documentation should clearly describe the patient's speech or voice symptoms, their severity, duration, and impact on the patient's daily life. Any known or suspected underlying conditions should also be documented.

Clinical Information:

  • Detailed description of the speech or voice symptom
  • Severity and duration of the symptom
  • Impact of the symptom on the patient's daily life
  • Any known or suspected underlying conditions
  • Any treatments or interventions performed

Supporting Evidence:

  • Clinical notes from the treating physician
  • Speech therapy evaluation reports
  • Neurological examination findings
  • Imaging or other diagnostic test results
Good Documentation Example:

Patient presents with severe hoarseness lasting for two weeks, impacting communication at work. Suspected laryngitis. Referred to ENT specialist.

Poor Documentation Example:

Patient has voice problem.

Common Documentation Errors:

  • Not documenting the severity or duration of the symptom
  • Not linking the symptom to any known or suspected underlying conditions
  • Not documenting the impact of the symptom on the patient's daily life

Range Statistics

3
Total Codes
4
Billable
Complexity:
Medium
Primary Use:Clinical Documentation
Chapter:18

Coding Complexity

Medium
Complexity Rating

The complexity of coding R57-R59 lies in understanding the nuances of different speech and voice disorders, knowing when to code the symptom versus the underlying condition, and accurately capturing the clinical context. Coders need to stay updated with the latest guidelines and be able to determine the level of specificity required for each case.

Key Factors:
  • Understanding the difference between various speech and voice disorders
  • Knowing when to use these codes versus when to code the underlying condition
  • Keeping up with changes and updates to the coding guidelines
  • Determining the level of specificity required for each case
  • Understanding the clinical context and impact of the symptom

Specialty Focus

R57-R59 codes are commonly used in specialties dealing with speech and voice disorders, such as otolaryngology, neurology, and speech therapy.

Primary Specialties:
Otolaryngology
40%
Neurology
30%
Speech Therapy
30%
Clinical Scenarios:
  • A patient with Parkinson's disease presenting with dysarthria.
  • A patient with severe hoarseness due to suspected laryngitis.
  • A child with stuttering impacting his school performance.
  • A patient with voice changes post thyroid surgery.
  • A patient with aphonia following a severe emotional trauma.

Resources & References

Resources for R57-R59 coding include the ICD-10-CM official guidelines, clinical reference books, coding training materials, and professional coding forums.

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:

  • Merck Manual
  • Mayo Clinic website

Educational Materials:

  • AHIMA coding webinars and training materials
  • AAPC coding forums and resources

Frequently Asked Questions

Can I use R57-R59 codes if the underlying condition is known?

If the underlying condition is known and has a specific code in the ICD-10, that code should be used instead. R57-R59 codes are typically used when the symptom is significant but the underlying condition is unknown or not yet diagnosed.