ICD-10 Case Study

Patient was referred to me by a friend of his family. When I met him he was 7-years-old, in second grade, and getting some speech therapy at his public school. He was a late talker; his father said he was not really putting words together until he was age three. When he did begin talking, his sentences were immature-sounding and even in kindergarten and first and second grade he was making below-age-level grammar mistakes.

He was also having difficulty with syntax, especially question syntax so that when he asked me, “how that get in there?” he meant “how did that get in there?” He also had difficulty with precisely expressing his thoughts in specific words and phrases. This reflected problems with word retrieval, choosing just exactly the word needed to express his intent, and it also included difficultly organizing his thoughts into sentences that exactly expressed his intent. We worked in speech therapy identifying the specific grammar targets and practicing their appropriate use first in drills and then in conversation, and also teaching strategies to help with word retrieval.

Expressive language disorders include developmental dysphasia or aphasia of the expressive type. This case would be coded F80.1 Expressive language disorder.

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Rhonda Buckholtz

Rhonda Buckholtz, CPC, CPMA, CPC-I, CENTC, CGSC, COBGC, CPEDC,has more than 20 years of experience in healthcare, working in the reimbursement, billing, and coding sectors, in addition to being an instructor. She is responsible for all ICD-10 training and curriculum at AAPC. She has authored many articles for health care publications and has spoken at conferences across the country. She is co-chair for the WEDI ICD-10 Implementation Workgroup and has provided testimony ongoing for ICD-10 and standardization of data for NCVHS. She also sits on the Provider Outreach and Education committee for Novitas Solutions (formerly Highmark Medicare Services).

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