What is the Sensory Processing Disorder ICD-10 Code?

Published by: Autism Parenting Magazine
Written by: Yolande Loftus

Obtaining reimbursement for the treatment of sensory processing disorder may be tricky when a billable code to specify the diagnosis is a requirement. Certain classification systems may not even recognize the disorder—is the ICD-10-CM the code that legitimizes sensory processing disorder?

Sensory processing disorder (SPD) has an almost ghost-like presence in the medical world. Some doctors—mostly conventional—simply do not believe it is or should ever be a distinct disorder. Others seem almost frightened when parents mention their child’s meltdown triggered by the sound of a hoover.

With a mountain of evidence spelling out how just how severely sensory processing disorder affects children, why is there still so much scepticism? Some believe the exclusion of sensory processing disorder as a separate diagnosis in the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM–5; American Psychiatric Association, 2013) may be behind some of the doctors’ persistent doubts.

The DSM-5 is used by professionals, mainly in the US, to diagnose mental disorders. The disorder not receiving it’s own listing in this influential manual may have far reaching consequences for treatment and access to appropriate interventions.

But what about international standards and classifications of diseases and health conditions? At first glance The World Health Organization’s International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) seems a little more inclusive of sensory processing conditions.

A diagnostic debate

The ICD-10-CM classification system refers to “Sensory integration disorder” as an “Approximate Synonym” under the F88 code: a billable/specific code that could be utilized to indicate a diagnosis for reimbursement purposes.

Does this legitimize sensory processing disorders, and does it mean the condition deserves a separate medical diagnosis? Many doctors believe sensory processing issues merely form part of the symptoms of recognized conditions and disorders like autism and attention deficit hyperactivity disorder (ADHD). Doctors along with researchers argue that there is simply not enough proof to confirm the existence of the condition according to scientific standards.

Such arguments do create a bit of a chicken and egg situation: if the condition is not legitimized will expensive clinical studies be funded and undertaken? And without such studies how will SPD ever be deemed worthy of a distinct and official medical diagnosis? Click here to read the rest of the story.

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