How To Use CPT Code 92523

CPT 92523 is a code used for the evaluation of speech sound production and language comprehension and expression. This article will cover topics such as the description, procedure, qualifying circumstances, usage, documentation requirements, billing guidelines, historical information, similar codes, and examples of CPT 92523.

1. What is CPT 92523?

CPT 92523 is a code used by speech-language pathologists (SLPs) to bill for the evaluation of a patient’s speech sound production and language comprehension and expression. This comprehensive assessment helps identify any issues with the patient’s communication abilities, emerging skills, mastered skills, and challenged areas. If the evaluation reveals that the patient may need therapy to improve speech sound production, the SLP may recommend speech therapy.

2. 92523 CPT code description

The official description of CPT code 92523 is: “Evaluation of speech sound production (e.g., articulation, phonological process, apraxia, dysarthria); with evaluation of language comprehension and expression (e.g., receptive and expressive language)”.

3. Procedure

The procedure for CPT 92523 involves the following steps:

1. The SLP conducts a thorough evaluation of the patient’s speech sound production, including articulation, phonological process, apraxia, and dysarthria.
2. The SLP assesses the patient’s language comprehension (receptive language) and expression (expressive language) using standardized testing.
3. The SLP analyzes the results of the assessment to determine the patient’s communication abilities, emerging skills, mastered skills, and challenged areas.
4. If necessary, the SLP may recommend speech therapy to address any identified issues with speech sound production or language comprehension and expression.

4. Qualifying circumstances

Patients who are eligible to receive CPT code 92523 services include those who:

• Have difficulty with speech sound production, such as articulation, phonological process, apraxia, or dysarthria.
• Struggle with language comprehension (receptive language) or expression (expressive language).
• Require a comprehensive assessment of their communication abilities to determine the need for speech therapy.
• Have not had a recent evaluation of their speech and language skills, or have experienced a significant change in their communication abilities since their last evaluation.

5. When to use CPT code 92523

It is appropriate to bill the 92523 CPT code when a speech-language pathologist conducts a comprehensive evaluation of a patient’s speech sound production and language comprehension and expression. This evaluation is necessary to identify any issues with the patient’s communication abilities and determine if speech therapy is needed to address these concerns.

6. Documentation requirements

To support a claim for CPT 92523, the following information should be documented:

• A detailed description of the patient’s speech sound production, including any issues with articulation, phonological process, apraxia, or dysarthria.
• A thorough assessment of the patient’s language comprehension (receptive language) and expression (expressive language), including standardized test results.
• An analysis of the patient’s communication abilities, emerging skills, mastered skills, and challenged areas.
• If applicable, a recommendation for speech therapy to address any identified issues with speech sound production or language comprehension and expression.
• Any relevant medical history, previous evaluations, or therapy services the patient has received.

7. Billing guidelines

When billing for CPT code 92523, it is important to follow these guidelines:

• Ensure that the patient meets the qualifying circumstances for receiving CPT 92523 services.
• Document all required information to support the claim, as outlined in the documentation requirements section.
• Use the appropriate modifiers, if necessary, to indicate any special circumstances related to the service provided.
• Be aware of any payer-specific rules or guidelines that may apply to CPT code 92523.

8. Historical information

CPT 92523 was added to the Current Procedural Terminology system on January 1, 2014. There have been no updates to the code since its addition.

9. Similar codes to CPT 92523

Five similar codes to CPT 92523 and how they differ are:

• CPT 92521: This code is used for the evaluation of speech fluency (e.g., stuttering, cluttering) only, without the assessment of speech sound production or language comprehension and expression.
• CPT 92522: This code is used for the evaluation of speech sound production only, without the assessment of language comprehension and expression.
• CPT 92524: This code is used for the evaluation of voice and resonance only, without the assessment of speech sound production or language comprehension and expression.
• CPT 92526: This code is used for the treatment of swallowing dysfunction and/or oral function for feeding, without the evaluation of speech sound production or language comprehension and expression.
• CPT 92507: This code is used for speech and language therapy services, rather than the evaluation of speech sound production and language comprehension and expression.

10. Examples

Here are 10 detailed examples of CPT code 92523 procedures:

1. A 5-year-old child with a history of speech delays undergoes a comprehensive evaluation of speech sound production and language comprehension and expression to determine the need for speech therapy.
2. An adult who has experienced a traumatic brain injury receives a CPT 92523 evaluation to assess their communication abilities and determine appropriate treatment interventions.
3. A teenager with a history of stuttering undergoes a CPT 92523 evaluation to assess their speech sound production and language comprehension and expression, in addition to their fluency.
4. A patient with autism spectrum disorder receives a CPT 92523 evaluation to assess their communication abilities and determine the need for speech therapy services.
5. An individual with a history of hearing loss undergoes a CPT 92523 evaluation to assess their speech sound production and language comprehension and expression following cochlear implant surgery.
6. A patient with aphasia due to a stroke receives a CPT 92523 evaluation to assess their communication abilities and determine appropriate treatment interventions.
7. An adult with a diagnosis of Parkinson’s disease undergoes a CPT 92523 evaluation to assess their speech sound production and language comprehension and expression, as well as their voice and resonance.
8. A child with a cleft palate receives a CPT 92523 evaluation to assess their speech sound production and language comprehension and expression following surgical repair.
9. An individual with a history of laryngeal cancer undergoes a CPT 92523 evaluation to assess their communication abilities following treatment.
10. A patient with Down syndrome receives a CPT 92523 evaluation to assess their speech sound production and language comprehension and expression, as well as their oral motor skills for feeding and swallowing.