R49.21 Hypernasality

ICD10CM code

#### Name of the Condition
- Hypernasality
- Also known as nasality, excessive nasal resonance.

#### Summary
Hypernasality is a condition characterized by excessive nasal resonance during speech. It occurs when air escapes through the nose, leading to a nasal sounding voice. This can impact speech clarity and articulation.

#### Causes
- Cleft palate or other congenital structural abnormalities
- Neurological disorders affecting muscle control
- Surgery, trauma, or tumors impacting the velopharyngeal mechanism

#### Risk Factors
- Genetic predisposition to structural abnormalities
- History of conditions affecting the nervous system
- Previous surgeries affecting the oral or nasal cavities

#### Symptoms
- Nasal-sounding speech
- Difficulty in producing certain consonants
- Lowered speech intelligibility

#### Diagnosis
- Auditory-perceptual evaluation by a speech-language pathologist
- Nasometry to measure nasal and oral sound energy
- Visualization of the velopharyngeal port via nasopharyngoscopy

#### Treatment Options
- Speech therapy to improve articulation and voice resonance
- Surgical interventions to correct structural abnormalities
- Use of prosthetic devices (e.g., palatal lift) for velopharyngeal inadequacy

#### Prognosis and Follow-Up
- With appropriate treatment, many individuals can achieve significant improvement.
- Regular follow-up with a speech-language pathologist is crucial for monitoring progress and adjusting treatment plans.

#### Complications
- If untreated, it can lead to social and communication difficulties
- Potential academic or occupational challenges due to speech impairment

#### Lifestyle & Prevention
- Early intervention in congenital cases can prevent the development of hypernasality.
- Regular speech evaluations for at-risk children can aid in early detection and treatment.

#### When to Seek Professional Help
- If speech becomes noticeably nasal or difficult to understand
- Any concerns regarding speech development in children

#### Additional Resources
- American Speech-Language-Hearing Association (ASHA): [asha.org](https://www.asha.org/)
- National Institute on Deafness and Other Communication Disorders: [nidcd.nih.gov](https://www.nidcd.nih.gov/)
- Cleft Palate Foundation: [www.cleftline.org](http://www.cleftline.org/)

#### Tips for Medical Coders
- Ensure that symptoms align with hypernasality before coding.
- Check for any underlying structural abnormalities or related diagnoses.
- Avoid confusing with other voice disorders that do not involve nasal resonance.

Medical Policies and Guidelines for Hypernasality

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