R49.1: Aphonia
R49.1, aphonia, is listed as a covered diagnosis in 9 Medicare billing and coding articles that apply to 8 HCPCS Level II codes, including G0451 (Development testing, with interpretation and report, per…), G0153 (Services performed by a qualified speech-language…), G0161 (Services performed by a qualified speech-language…). The articles come from 5 Medicare contractors. A listed diagnosis supports medical necessity only; coverage still depends on the LCD's criteria and on documentation in the medical record.
HCPCS Level II codes with R49.1 as a covered diagnosis
| Code | Description | Medicare coverage | DMEPOS fee 2026 (state range) | Articles listing it |
|---|---|---|---|---|
| G0451 | Development testing, with interpretation and report, per standardized instrument form | Carrier judgment | — | 2 |
| G0153 | Services performed by a qualified speech-language pathologist in the home health or hospice setting, each 15 minutes | Carrier judgment | — | 1 |
| G0161 | Services performed by a qualified speech-language pathologist, in the home health setting, in the establishment or delivery of a safe and effective speech-language pathology maintenance program, each 15 minutes | Carrier judgment | — | 1 |
| G0410 | Group psychotherapy other than of a multiple-family group, in a partial hospitalization or intensive outpatient setting, approximately 45 to 50 minutes | Carrier judgment | — | 1 |
| G0017 | Psychotherapy for crisis furnished in an applicable site of service (any place of service at which the non-facility rate for psychotherapy for crisis services applies, other than the office setting); first 60 minutes | Carrier judgment | — | 1 |
| G0018 | Psychotherapy for crisis furnished in an applicable site of service (any place of service at which the non-facility rate for psychotherapy for crisis services applies, other than the office setting); each additional 30 minutes (list separately in addition to code for primary service) | Carrier judgment | — | 1 |
| G0411 | Interactive group psychotherapy, in a partial hospitalization or intensive outpatient setting, approximately 45 to 50 minutes | Carrier judgment | — | 1 |
| G0255 | Current perception threshold/sensory nerve conduction test, (snct) per limb, any nerve | Non-covered by Medicare | Not covered | 5 |
Medicare policy articles listing R49.1
- A52866: Billing and Coding: Speech-Language Pathology (Wellpoint Federal (MAC - Part A, MAC - Part B); 1 Level II codes). LCD with the same title: L33580, L34046
- A53052: Billing and Coding: Home Health Speech-Language Pathology (Palmetto GBA (HHH MAC); 2 Level II codes). LCD with the same title: L34563
- A57480: Billing and Coding: Psychiatry and Psychology Services (WPS Insurance Corporation (MAC - Part A, MAC - Part B); 4 Level II codes). LCD with the same title: L33632, L34616
- A57307: Billing and Coding: Nerve Conduction Studies and Electromyography (CGS Administrators, LLC (MAC - Part A, MAC - Part B); 1 Level II codes). LCD with the same title: L34594, L34859, L35048, L35081
- A57478: Billing and Coding: Nerve Conduction Studies and Electromyography (WPS Insurance Corporation (MAC - Part A, MAC - Part B); 1 Level II codes). LCD with the same title: L34594, L34859, L35048, L35081
- A56937: Billing and Coding: Psychiatry and Psychology Services (Wellpoint Federal (MAC - Part A, MAC - Part B); 1 Level II codes). LCD with the same title: L33632, L34616
- A54969: Billing and Coding: Nerve Conduction Studies and Electromyography (Noridian Healthcare Solutions, LLC (MAC - Part A, MAC - Part B); 1 Level II codes). LCD with the same title: L34594, L34859, L35048, L35081
- A57668: Billing and Coding: Nerve Conduction Studies and Electromyography (Wellpoint Federal (MAC - Part A, MAC - Part B); 1 Level II codes). LCD with the same title: L34594, L34859, L35048, L35081
- A56619: Billing and Coding: Nerve Conduction Studies and Electromyography (Palmetto GBA (MAC - Part A, MAC - Part B); 1 Level II codes). LCD with the same title: L34594, L34859, L35048, L35081
A diagnosis listed as covered in a billing and coding article supports medical necessity for the article's codes; it does not guarantee payment. Coverage depends on the LCD's criteria, the contractor's jurisdiction and documentation in the medical record.
Other R49 diagnoses (Voice and resonance disorders)
- R49.0 — Dysphonia
- R49.21 — Hypernasality
- R49.22 — Hyponasality
- R49.8 — Other voice and resonance disorders
Frequently asked questions
Does Medicare cover R49.1 (Aphonia)?
Medicare covers items and services, not diagnoses. 9 Medicare billing and coding articles list R49.1 as a covered diagnosis for 8 HCPCS Level II codes: the diagnosis can support medical necessity for those codes, but payment still depends on the LCD's coverage criteria and the medical record.
Which HCPCS codes can be billed with ICD-10 R49.1?
The Level II codes from the policies most specific to this diagnosis are G0451 (Development testing, with interpretation and report, per…, 2 articles); G0153 (Services performed by a qualified speech-language…, 1 article); G0161 (Services performed by a qualified speech-language…, 1 article); G0410 (Group psychotherapy other than of a multiple-family group…, 1 article); G0017 (Psychotherapy for crisis furnished in an applicable site…, 1 article). Code choice depends on the item supplied; check each code's descriptor.
Which Medicare policy articles list R49.1?
A52866 (Billing and Coding: Speech-Language Pathology); A53052 (Billing and Coding: Home Health Speech-Language Pathology); A57480 (Billing and Coding: Psychiatry and Psychology Services), and 6 more articles.
What is ICD-10-CM code R49.1?
R49.1 is the ICD-10-CM code for aphonia, in category R49 (Voice and resonance disorders), chapter 18: Symptoms, signs and abnormal findings.
Next steps
- Run a reimbursement report for a device billed under G0451
- Watch G0451 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for G0451
Sources: CMS Medicare Coverage Database billing and coding articles (covered ICD-10 code lists and HCPCS links); ICD-10-CM FY2026; CMS HCPCS Level II release October 2026; CMS DMEPOS fee schedule 2026 (non-rural state fees). Not billing or legal advice.
Chapter 18: Symptoms, signs and abnormal findings · All diagnoses · HCPCS lookup