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, CRC, CDEO, CMPE, CHC, COPC, AAPC Approved Instructor, is owner of Coding and Reimbursement Experts. She spends her time helping physician practices achieve operational excellence, compliance, education, and Lean Six Sigma through her consulting. Buckholtz has more than 30 years of experience in healthcare management, compliance, and reimbursement/coding sectors. She was responsible for all ICD-10 training and curriculum at AAPC during the transition from ICD-9. Buckholtz has authored numerous articles for healthcare publications and she has spoken at numerous national conferences for AAPC and others. She is past co-chair for the WEDI ICD-10 Implementation Workgroup, Advanced Payment Models Workgroup, and she provided testimony for ICD-10 and standardization of data for National Committee on Vital and Health Statistics. Buckholtz is on AAPC’s National Advisory Board.

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