Speech-Language Pathology ICD-10-CM Code Changes for 2025

The following new and revised ICD-10-CM (International Classification of Diseases, 10th Revision, Clinical Modification) codes are effective October 1, 2024, for fiscal year (FY) 2025. ICD-10-CM codes are updated annually. For past updates, see speech-language pathology ICD-10-CM code changes for 2024 and 2023.

Note: Always check with payers regarding coverage of new or revised ICD-10-CM codes. Coding changes may not always alter payer coverage decisions for specific conditions.

On this page:

Summary of Changes
Dementia
Rumination
Cognitive Deficits
Resources

Summary of Changes

There are no major changes to ICD-10-CM codes directly related to speech, language, cognitive, swallowing, or voice disorders for FY 2025.

However, SLPs should be aware that the 2025 ICD-10-CM updates codes related to dementia, secondary parkinsonism, and rumination, including revised code descriptors. It also adds a key new requirement to code the underlying condition first, if known, when reporting the R41.84- series of codes for cognitive deficits.

The following list of changes only outlines the latest updates to the codes. For a full list of the codes relevant to SLPs, with instructional notes, see ASHA's resource on ICD-10-CM Diagnosis Codes Related to Speech, Language, and Swallowing Disorders [PDF]. For a full list of annula changes to the ICD-10-CM code set, see the NCHS 2025 release of ICD-10-CM.

Dementia

F02

Dementia in other diseases classified elsewhere

Code first the underlying physiological condition, such as:
neurocognitive disorder with Lewy bodies (G31.83) (added to the list of underlying conditions)
other frontotemporal neurocognitive disorder (G31.90) (added to the list of underlying conditions)

F05

Dementia with delirium or acute confusional state (existing code with new code descriptor)

G21

Secondary parkinsonism
Excludes1: neurocognitive disorders with Lewy bodies (G31.83) (new exclusion)

ASHA Notes

For G21, the new addition to the “Excludes1” list means that G31.83 cannot be reported in conjunction with G21.
SLPs may use these updated ICD-10-CM codes to provide additional detail regarding an underlying or coexisting condition to the speech, language cognitive, swallowing, or voice disorder.
Consult the medical record or referring physician before reporting these medical diagnoses in addition to the treating diagnosis on the claim.

Rumination

F50.84

Rumination disorder in adults (new code)
Rumination disorder in adults, in remission

Excludes1: rumination disorder in infancy and childhood (F98.21)

F98.21

Rumination disorder of infancy and childhood (existing code with new code descriptor)

Rumination disorder in infancy or childhood, in remission

Excludes1: rumination disorder in adults (F50.84)

ASHA Notes

SLPs typically do not assign codes from the F50- series for eating disorders, but rather R6.31 (pediatric feeding disorder, acute) or R63.32 (pediatric feeding disorder, chronic), or the R13.1- series of codes for dysphagia.
Physicians or specialists, such as psychologists, may use the F50- codes to refer to SLPs for evaluation and treatment of feeding and swallowing disorders.

Cognitive Deficits

R41.84

Other specified cognitive deficit (section header, not a billable code)
Code first the underlying condition, if known, such as: Schizophrenia (F20.-) (new “code first” note)

ASHA Notes

The “code first” note means that the underlying condition contributing to the cognitive deficit must always be reported first, followed by the SLP’s treating diagnosis―in this case, any of the codes in the R41.84- series of codes related to other specified cognitive deficits.
- Schizophrenia is listed as an example in the "code first" note. This does not mean that schizophrenia is the only code that should be reported with the R41.84- series of codes.
Consult the medical record or referring physician before reporting the underlying medical diagnoses with the treating diagnosis on the claim.