Schedule of ratings—other sense organs

Sense of smell, complete loss 

Anosmia is the inability to smell. Some people have anosmia from birth, whereas others lose their ability to smell over time. Experts suggest that anosmia and hyposmia affect about 3–20% of the population. Hyposmia is a decreased ability to smell. Sometimes people call anosmia smell blindness. The condition may be permanent or temporary.

Smell is a complex process that involves communication between the brain and nose. When a person sniffs an odor, air travels into the nose, and the odor molecules attach to receptors on the nerve that sense smell, called the olfactory nerve. These nerves line the olfactory epithelium, which is the tissue lining the nasal cavity. When odor molecules from the environment stimulate these nerves, they transmit signals to the brain. The brain receives the olfactory information and processes it into a scent that a person can identify.

Causes 

There are many common conditions that can cause anosmia to develop. These may include:

• Nasal polyps.
• Common cold.
• Influenza (flu).
• Nasal congestion.
• A deviated septum.
• Sinus infection (sinusitis).
• Hay fever or other allergies.
• Anosmia has also be linked to:
• Diabetes.
• Smoking.
• Obesity.
• High blood pressure (hypertension).
• Kallmann’s syndrome.
• Alzheimer’s disease.
• Certain medications, such as antibiotics and antihistamines.
• Multiple sclerosis (MS).
• Parkinson’s disease.
• Sjogren’s syndrome.
• Traumatic brain injury.
• Brain tumors.

Symptoms

Symptoms can range from not being able to smell or taste at all to the reduced ability to smell or taste specific things that are sweet, sour, bitter or salty. In some cases, normally pleasant tastes or smells may become unpleasant.

Diagnosis 

The loss of smell is difficult to measure. Your doctor may ask you some questions about your current symptoms, examine your nose, perform a complete physical examination, and ask about your health history.

They may ask questions about when the problem started, if all or only some types of odors are affected, and whether or not you can taste food. Depending on your answers, your doctor may also perform one or more of the following tests:

• CT scans, which use X-rays to create a detailed image of the brain
• MRI scans, which uses radio waves and magnets to view the brain
• X-ray of the skull
• nasal endoscopy to look inside your nose

Note: Evaluation will be assigned under diagnostic codes 6275 or 6276 only   there is an anatomical or pathological basis for the condition. 

Sense of taste, complete loss 

Ageusia is a rare condition that is characterized by a complete loss of taste function of the tongue. It requires differentiation from other taste disorders such as hypogeusia (decreased sensitivity to all tastants), hypogeusia (enhanced gustatory sensitivity), dysgeusia (unpleasant perception of a tastant), and phantogeusia (perception of taste that occurs in the absence of a tastant). Although ageusia is not a life-threatening condition, it can cause discomfort. It can lead to loss of appetite, reduction in weight, and in some cases, may require discontinuation of drugs in already compromised patients; this can result in medical problems and can have a severe psychological impact on the patient.

Causes 

Several things can trigger a loss of taste. They include:

• Damage to your taste sensation nerve
• Not getting enough of certain nutrients
• Hypothyroidism
• Diabetes
• Pernicious anemia
• Sjogren’s syndrome
• Crohn’s disease
• Tongue injury (inflammation, burns, surgery, cuts, or anesthesia)
• Infection
• Dental work complications
• Cranial nerve lesions
• Iatrogenic lesions, nerve damage caused by medical treatment
• Neuralgia, severe shooting pain from nerve irritation or damage
• Polyneuropathies, when several nerves don’t work the right way

For example, people with cancer in their head or neck might get radiation that causes ageusia. That’s because radiation therapy can injure your taste buds and transmit nerves. It can also affect the flow of saliva if it damages your salivary glands.

Certain drugs may also lead to ageusia. They include:

• Antibiotics
• Antineoplastic agents (chemotherapy drugs)
• Neurologic medications
• Cardiovascular drugs
• Antipsychotics
• Tranquilizers
• Tricyclic antidepressants
• Thyroid medications
• Antihistamines
• Bronchodilators
• Antifungals
• Antivirals
• Aging and things related to it might also affect your ability to taste, but they usually don’t lead to a complete loss of taste.

Symptoms 

People with ageusia cannot distinguish any taste in the foods they eat. Additionally, they may experience a number of other symptoms. These may include:

• A decreased desire to eat.
• High blood pressure (hypertension).
• Nasal congestion.
• Allergies.
• Oral health problems.

Diagnosis

First, your health care provider will ask questions about the taste changes and medical history and complete a physical exam. They may do a few tests like:

• Taste tests to compare different tastes and the lowest strength you’re able to sense
• Sniff tests (tests the sense of smell)
• Imaging (to assess the nerve health)

The health care provider will rule out possible causes of taste loss like medications or loss of smell.