Diagnosing requires the healthcare provider to identify and label a condition that the practitioner is responsible for treating. Coding systems are often used to differentiate diagnoses. Accurate and consistent application of diagnostic codes yields valid and reliable data on health utilization, costs, quality improvement and research outcomes. In the U.S., the term Pediatric Feeding Disorder (R63.3) was approved and included in the International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10).
PEDIATRIC FEEDING DISORDER (PFD) IS THE RECOMMENDED TERM
Pediatric Feeding Disorder is not an eating disorder as described in DSM-5. It is also not related to food insecurity or congruent with cultural norms.
To support consistent diagnostic coding, the term Pediatric Feeding Disorder has been added to the Alberta Health Services provincial clinical informatics system Connect Care. In areas with alternative clinical informatics systems, consistent use of the term Pediatric Feeding Disorder is still recommended. Other terms can be used to describe associated conditions including but not limited to:
- Dysphagia (oral phase, oropharyngeal phase, pharyngeal phase, pharyngoesophageal phase, unspecified)
- Feeding difficulties, feeding difficulty in newborn
- Avoidant Restrictive Food Intake Disorder (ARFID)
- A psychiatric disorder with anxiety resulting in nutrition sequelae as described in DSM-5.
- It is important to rule out underlying medical or skill dysfunction as the diagnostic criteria for ARFID can overlap with PFD.
Benefits of using the Pediatric Feeding Disorder diagnostic term include:
- consistent messaging for parents and families
- awareness and consistent identification of children with pediatric feeding disorder
- better understanding of conditions associated with PFD across health domains
- accurate calculation of prevalence data in Alberta
- referral to the appropriate health care professionals.
Clinicians may progressively record diagnoses identified for each of the five assessment questions and associated domains, and their management considerations. Consideration of the combined results, and reference to the management section of the guide, can then be undertaken to develop and prioritize key management goals (NSW Office of Kids and Families, 2016).