How To Use CPT Code 92610

CPT 92610 is a code used for the evaluation of oral and pharyngeal swallowing function, and this article will cover its description, procedure, qualifying circumstances, usage, documentation requirements, billing guidelines, historical information, similar codes, and examples.

1. What is CPT 92610?

CPT 92610 is a medical code used to describe the evaluation of a patient’s oral and pharyngeal swallowing function. This procedure is typically performed by a speech-language pathologist (SLP) and involves assessing the patient’s ability to chew food, form a bolus, and swallow different types of food and liquids. The evaluation also includes examining oral motor skills, laryngeal function, reflexes, and a wide range of communication problems resulting from damage to the regions of the brain.

2. 92610 CPT code description

The official description of CPT code 92610 is: “Evaluation of oral and pharyngeal swallowing function.”

3. Procedure

The 92610 procedure involves the following steps:

1. The patient is oriented and helped to understand the procedure by slowing the rate of speech and using short phrases.
2. The SLP evaluates the patient’s oral motor skills, laryngeal function, reflexes, and communication problems.
3. The patient’s tongue tip elevation and movement of the anteroposterior tongue are assessed, as well as smile/lip pucker/cockle.
4. The patient is presented with a variety of foods/textures to determine the oral phase of the swallow and to identify any signs of pharyngeal dysphagia.
5. The SLP evaluates laryngeal elevation, delayed initiation of volitional swallow, choking, and questionable pharyngeal residue.
6. Once the evaluation is successfully completed, the physician may recommend a nasogastric (NG) tube for nutrition, hydration, and medications, and advise maintaining NPO status.

4. Qualifying circumstances

Patients who are eligible to receive CPT code 92610 services include those with:

• Difficulty swallowing or a history of swallowing problems
• Neurological disorders affecting swallowing function, such as stroke, Parkinson’s disease, or multiple sclerosis
• Head and neck cancer or a history of head and neck surgery
• Chronic respiratory conditions that may affect swallowing function
• Other medical conditions or injuries that may impact the patient’s ability to swallow safely and effectively

5. When to use CPT code 92610

It is appropriate to bill the 92610 CPT code when a patient presents with symptoms or a history of swallowing difficulties, and a comprehensive evaluation of their oral and pharyngeal swallowing function is required. This evaluation is necessary to determine the underlying cause of the patient’s swallowing problems and to develop an appropriate treatment plan.

6. Documentation requirements

To support a claim for CPT 92610, the following information should be documented:

• Patient’s medical history, including any relevant diagnoses or conditions that may affect swallowing function
• Details of the patient’s symptoms and the duration of their swallowing difficulties
• Results of the oral and pharyngeal swallowing function evaluation, including findings related to oral motor skills, laryngeal function, reflexes, and communication problems
• Assessment of the patient’s ability to swallow different types of food and liquids
• Recommendations for further testing or treatment, such as the use of a nasogastric (NG) tube or modifications to the patient’s diet

7. Billing guidelines

When billing for CPT code 92610, it is important to follow these guidelines:

• Ensure that the patient meets the qualifying circumstances for the procedure
• Document all necessary information to support the claim, as outlined in the documentation requirements section
• If the procedure is performed on the same day as another related service, such as CPT code 92611 (motion fluoroscopic evaluation of swallowing function), append modifier 59 (Distinct procedural service) to 92610 on the claim form to ensure both services are reimbursed
• Ensure that the SLP who performed the evaluation is properly credentialed and licensed to provide the service

8. Historical information

CPT 92610 was added to the Current Procedural Terminology system on January 1, 2003. There have been no updates to the code since its addition.

9. Similar codes to CPT 92610

Five similar codes to CPT 92610 and how they differ are:

• CPT 92611: This code is used for motion fluoroscopic evaluation of swallowing function, which involves the use of fluoroscopy to visualize the patient’s swallowing process.
• CPT 92612: This code is used for flexible endoscopic evaluation of swallowing, which involves the use of a flexible endoscope to examine the patient’s upper gastrointestinal tract during swallowing.
• CPT 92613: This code is used for flexible endoscopic evaluation of swallowing with sensory testing, which adds sensory testing to the flexible endoscopic evaluation of swallowing procedure.
• CPT 92614: This code is used for laryngeal sensory testing, which involves the assessment of laryngeal sensation and function during swallowing.
• CPT 92615: This code is used for therapeutic services for swallowing disorders and/or oral function for feeding, which involves the provision of therapy to improve the patient’s swallowing function and/or oral feeding abilities.

10. Examples

Here are 10 detailed examples of CPT code 92610 procedures:

1. A patient with a history of stroke presents with difficulty swallowing and requires an evaluation of their oral and pharyngeal swallowing function.
2. A patient with Parkinson’s disease experiences choking while eating and requires an assessment of their swallowing abilities.
3. A patient who has undergone head and neck surgery presents with persistent swallowing difficulties and requires a comprehensive evaluation of their swallowing function.
4. A patient with multiple sclerosis experiences difficulty swallowing liquids and requires an evaluation to determine the cause and develop a treatment plan.
5. A patient with a chronic respiratory condition presents with coughing and choking during meals and requires an assessment of their oral and pharyngeal swallowing function.
6. A patient with a traumatic brain injury experiences difficulty swallowing and requires a comprehensive evaluation to determine the extent of their swallowing problems.
7. A patient with a history of esophageal cancer presents with persistent swallowing difficulties and requires an evaluation of their oral and pharyngeal swallowing function.
8. A patient with a neurological disorder experiences difficulty swallowing solids and requires an assessment to determine the cause and develop a treatment plan.
9. A patient with a history of radiation therapy to the head and neck region presents with swallowing difficulties and requires a comprehensive evaluation of their swallowing function.
10. A patient with a progressive neurological disease experiences difficulty swallowing and requires an evaluation to determine the extent of their swallowing problems and develop an appropriate treatment plan.