Ankylolarynx?

[SEllner418@aol.com (SEllner418@aol.com)]

>From time to time I see ventilator dependent patients who appear to be
dysphagic secondary to the tethering effects of the trach tube on the larynx.
 In my facility, I need to supply a medical diagnosis and a rehab. diagnosis
for each patient I evaluate, and each diagnosis needs an ICD-9 code. 

I'm interested in learning how others are handling the medical diagnosis in
cases like this.  When the patient is on a vent because of respiratory
failure, I have been listing  "respiratory failure" as the medical diagnosis,
but since respiratory failure is not in and of itself the reason for the
dysphagia, it's probably only a matter of time until our Medicare
intermediary denies payment.  

ICD-9 codes are used to help specify diseases and medical conditions, but
there are V codes for mechanical problems that seem as though they might help
solve my problem.  I found a V code for tracheostomy, but I don't know how to
use it.  Can someone explain how to use V codes?  Is there a more appropriate
V code or medical condition that could be used as a medical diagnosis here?

Help!

Scott