IMPORTANT: New Diagnostic Codes for Stuttering
As of October 1, 2010, there are several new diagnostic codes for stuttering:
- 307.0: Adult-onset stuttering (possibly psychogenic in origin)
- 315.35: Childhood-onset stuttering and cluttering
- 438.14: Fluency disorder due to cerebrovascular accident (CVA, stroke)
- 784.52: Fluency disorder due to other conditions such as Parkinson's Disease
The impact of these new codes on insurance reimbursement is not yet clear, but it is hoped that having a new code for childhood-onset stuttering that place it with developmental delays rather than emotional problems will underscore the fact that stuttering is typically not a psychological problem. The other codes will also help to emphasize the differences in origin of different types of stuttering.
Getting Adequate Insurance Coverage
Obtaining Insurance coverage for stuttering therapy often poses a significant challenge for families of children who stutter. Craig Coleman, former co-director of the the Stuttering Center, served as chair of the National Stuttering Association's Insurance Advocacy Committee to develop material to help families successfully obtain appropriate insurance coverage.
For information about insurance coverage, read the Insurance Advocacy Brochure, available for FREE from the National Stuttering Association. The brochure was created by Craig Coleman, Joe Donaher, PhD, Rod Gabel PhD, Lisa LaSalle PhD, Andy McMillin, Jennifer Owen, Glen Tellis PhD, Holly Willet, & J. Scott Yaruss PhD.
If you are denied coverage and decide to file an appeal , the following sample appeal letters may be helpful. These letters, written by Craig Coleman, contain information that you can use to make the case that stuttering should be covered under your insurance plan or reimbursable under your Flexible Spending Account. The letters are in Microsoft Word format so you can edit them as necessary.
Of course, the final determination will be made by the insurance company, but we have found that appeals can help! Let us know if you have any questions!