Diagnosis pathway for patients with amyotrophic lateral sclerosis: retrospective analysis of the US Medicare longitudinal claims database

Table 1 Codes identified as high or moderate likelihood of being first ALS symptom

	Priority	Subgroup	Diagnosis of interest	ICD-9-CM codes
Bulbar	High	Speech	Developmental speech, language disorder	315.39
			Speech and language deficits (including aphasia, dysphasia, voice resonance disorder, speech disturbance, dysarthria)	438.1X, 784.3, 784.4X, 784.5X
			Dysphagia	787.2, 438.82
		Swallowing	Disturbance, salivary secretion	527.7
			Salivary gland disorder	527.8
			Pain, throat	784.1
Limb	High	Muscle strength	Atrophy, muscular disuse	728.2
Limb		Muscle strength	Muscle weakness (generalized)	728.87
		Gait	Difficulty walking	719.7
			Gait abnormality	781.2
			Lack of coordination	781.3
		Involuntary muscle movement	Cramping	729.82
			Spasm	728.85
			Twitching/fasciculation	781.0
		Myopathy	Myopathy (including myopathy with weakness)	359.X
	Moderate	Pain	Pain in joint	719.4
		Pain	Pain in limb	729.5
		Other	Disorder of muscle and/or ligament	728.X

ALS, amyotrophic lateral sclerosis; ICD-9-CM, International Classification of Diseases, Ninth Revision, Clinical Modification.

ISSN: 1471-2377