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ICD-10: Dysarthria is the code used by Speech-Language Pathologists for diagnosing a motor speech condition that can occur with many other speech and language disorders. R47 code; inclusion and exclusion criteria and signs and symptoms of dysarthria will be explained in this blog.
According to the American Speech-Language-Hearing Association (ASHA), Dysarthria can be defined as “a speech disorder caused by muscle weakness. It can make it hard for you to talk. People may have trouble understanding what you say.”
Whether you work with the pediatric population or with adults, as an SLP you’re likely to have at least a few clients on your caseload who have Dysarthria. There are a wide variety of causes for the speech disorder, including certain medications, brain injury, and various syndromes or disorders (including Cerebral Palsy and Parkinson’s Disease).
Because Dysarthria so frequently occurs with other speech and language diagnoses, SLPs need to understand the nature of the speech disorder and how to properly diagnose it.
Being knowledgeable about Dysarthria can also help Speech-Language Pathologists ensure they are following Medicaid and ASHA guidelines to document an ICD-10 code for certain clients to the highest degree of specificity.
Here’s what you need to know about Dysarthria, including what ICD-10 code to use for the disorder, criteria for symptoms of Dysarthria, and the top-recommended resources to guide your treatment.
ICD-10 for Dysarthria
SLPs are required to use ICD-10 codes when diagnosing clients and charging procedures. To stay compliant with HIPAA regulations and for payment by Medicare, Medicaid, and private insurance companies, therapists must use the most accurate, specific ICD-10 codes.
R47.1 is the ICD-10 code to use when diagnosing a client with Dysarthria.
| Disorder | ICD – 10 Code |
|---|---|
| Dysarthria | R47.1 |
According to the 2022 list of ICD-10 CM Diagnosis Codes related to Speech, Language, and Swallowing Disorders by the American Speech Language Hearing Association (ASHA), the ICD-10 code R47.1 should be used for a diagnosis of dysarthria and anarthria. This excludes dysarthria following cerebrovascular disease (I69. with final characters -22 should be used in that case).
The code for Dysarthria falls under the area of “Symptoms and signs involving speech and voice”.
When giving the diagnosis of ICD-10 R47.1 for Dysarthria, SLPs should be knowledgeable about the signs and symptoms of this speech disorder. This includes knowing how Dysarthria differs from other motor speech disorders, such as Apraxia.
Signs and Symptoms of Dysarthria
The Mayo Clinic reports, “Dysarthria occurs when the muscles you use for speech are weak or you have difficulty controlling them. Dysarthria often causes slurred or slow speech that can be difficult to understand.”
Common Causes of Dysarthria include:
- Disorders affecting the nervous system
- Conditions that cause weakness of oral/facial musculature or facial paralysis
- Certain medications
In the pediatric population, Dysarthria may be seen in children who have diagnoses such as Cerebral Palsy, Down Syndrome, or other genetic disorders, and those who have experienced a traumatic brain injury (TBI) or a brain tumor.
SLPs working with adults may see signs of Dysarthria in those individuals who have had a stroke, TBI, or a progressive neurological disease such as Parkinson’s Disease, Amyotrophic Lateral Sclerosis (ALS), and Muscular Dystrophy.
Dysarthria is not to be confused with another speech disorder known as Apraxia.
When giving a diagnosis of Dysarthria, SLPs need to remember that this speech disorder is characterized by weakness or oral musculature. This differs from Apraxia, which is a motor planning speech disorder in which sound errors are typically inconsistent and may be atypical.
Characteristics of Dysarthria include:
- Reduced precision during articulation of speech sounds
- Decreased speech intelligibility
- Slow speech
- Slurred speech
- Reduced movement of oral-facial muscles such as lips, tongue, and jaw
- Atypical intonation/monotone
- Abnormal or inconsistent speech volume
An individual does not have to demonstrate all of the above symptoms to have a diagnosis of Dysarthria. Clients with Dysarthria may demonstrate any number of these signs. The severity of a client’s Dysarthria can range from mild to severe.
Dysarthria can co-occur with other speech and language disorders. For example, a child may have both a mixed receptive-expressive language disorder and Dysarthria. An adult who has had a Cerebrovascular Incident may have Aphasia as well as Dysarthria
Prevalence of Dysarthria
According to ASHA, the true overall incidence and prevalence of Dysarthria are not fully known.
There are several estimates of the prevalence of Dysarthria as it is associated with common neurological diagnoses:
- 8% to 60% of those with Stroke
- 10-65% of individuals with TBI
- 70% to 100% in those with Parkinson’s disease
Childhood Dysarthria is estimated to be prevalent in 1 per 1,000 children at 4 to 8 years old, according to research.
When Not to Use the ICD-10 Code R47.1 for Dysarthria
SLPs are advised to use the ICD-10 code R47.1 for Dysarthria if the diagnosis is related to progressive neurological disease, nervous system condition, or medication.
If the client is showing signs of Dysarthria following cerebral infarction, cerebrovascular disease, intracerebral hemorrhage, or subarachnoid hemorrhage, among certain other neurological infarctions, a different series of ICD-10 codes should be used. These codes begin with I69.
SLPs should refer to the Center for Disease Control’s (CDC’s) ICD-10 lookup tool each year to ensure they are using the most accurate, up-to-date ICD Code
The ICD-10 code for Dysarthria can be used for a client in conjunction with codes that indicate language disorders, such as F80.1 Expressive Language Delay or F80.2 Mixed Receptive Expressive Language Disorder.
Assessment & Treatment for Individuals with Dysarthria
As mentioned, SLPs should differentiate Dysarthria from other speech sound disorders during an assessment.
An assessment for a client who is suspected to have Dysarthria may include:
- Oral Motor Examination (the clinician should take note of discoordination or difficulty consistently executing certain oral muscle movements).
- Speech sample (examine the vocal quality, pitch, prosody, and speech intelligibility).
- Extended reading or speech sample (look at whether the client’s speech intelligibility or prosody is reduced over time due to muscle weakness/fatigue).
- Standardized Articulation Assessment (such as the Goldman Fristoe Test of Articulation- 3rd Edition): to examine the client’s articulation and whether errors are due to weakness/reduced precision versus sound substitutions or phonological patterns.
- Formal Apraxia Assessment (such as the Kaufman Speech Praxis Test (KSPT), to make a diagnosis: Differential diagnosis is a list of possible conditions that may explain symptoms. সহজ বাংলা: একই লক্ষণের সম্ভাব্য রোগের তালিকা।" data-rx-term="differential diagnosis" data-rx-definition="Differential diagnosis is a list of possible conditions that may explain symptoms. সহজ বাংলা: একই লক্ষণের সম্ভাব্য রোগের তালিকা।">differential diagnosis or determine whether signs of both speech disorders are present).
- Case History (obtain information through interviewing the client and/or family, asking about symptoms, communication needs, and the impact of speech difficulties on their daily life).
Some individuals with severe Dysarthria may benefit from the use of Augmentative Alternative Communication, also known as AAC. AAC can help certain clients with Dysarthria communicate effectively with others when their verbal speech intelligibility is significantly reduced.
