How To Use CPT Code 92597

CPT 92597 describes the evaluation for use and/or fitting of a voice prosthetic device to supplement oral speech. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes and billing examples.

1. What is CPT Code 92597?

CPT 92597 can be used to describe the evaluation performed by a healthcare provider to determine the need for a voice prosthetic device and to fit the device for a patient. This code is used when the provider assesses the patient’s ability to effectively use the device and the functional communication goals that can be achieved with its use.

2. Official Description

The official description of CPT code 92597 is: ‘Evaluation for use and/or fitting of voice prosthetic device to supplement oral speech.’

3. Procedure

1. The healthcare provider evaluates the patient’s need for a voice prosthetic device and determines the specific device and accessories that should be used.
2. The provider measures the patient for the type of device and prepares the puncture site if necessary.
3. The device is inserted, and the provider confirms its placement, checks for leaks, and ensures that it is functioning properly.
4. The provider adjusts the device as necessary to ensure patient comfort and optimal performance.
5. The patient is taught how to care for and clean the device, as well as how to properly insert and remove it.
6. The provider provides instructions on how to make the device work effectively for the patient’s communication needs.

4. Qualifying circumstances

Patients eligible for CPT 92597 are those who require a voice prosthetic device to supplement their oral speech. This may include individuals who have had all or part of their larynx removed due to disease, such as cancer, or those who have a tracheostomy and require a speaking valve. The evaluation and fitting of the device must be performed by a qualified healthcare provider.

5. When to use CPT code 92597

CPT code 92597 should be used when a healthcare provider performs an evaluation for the use and/or fitting of a voice prosthetic device to supplement oral speech. This code is appropriate when assessing the patient’s need for the device and determining the specific device and accessories that should be used. It should not be used for other types of augmentative and alternative communication device services.

6. Documentation requirements

To support a claim for CPT 92597, the healthcare provider must document the following information:

• Patient’s need for a voice prosthetic device
• Specific device and accessories recommended for the patient
• Date and duration of the evaluation
• Confirmation of device placement and functionality
• Adjustments made to the device for patient comfort and optimal performance
• Instructions provided to the patient on device care, insertion, removal, and usage
• Signature of the healthcare provider performing the evaluation

7. Billing guidelines

When billing for CPT 92597, ensure that the evaluation and fitting of the voice prosthetic device are performed by a qualified healthcare provider. There are no specific guidelines regarding reporting CPT 92597 with other codes. However, it is important to follow any applicable payer guidelines and provide appropriate documentation to support the claim.

8. Historical information

CPT 92597 was added to the Current Procedural Terminology system on January 1, 1996. There have been no updates or changes to the code since its addition.

9. Examples

1. A speech-language pathologist evaluating a patient who had a laryngectomy for the use and fitting of a voice prosthetic device to supplement oral speech.
2. An otolaryngologist assessing a patient with a tracheostomy for the appropriate voice prosthetic device and fitting.
3. A healthcare provider evaluating a patient with a history of laryngeal cancer for the use of an electrolarynx to aid in speech.
4. A speech therapist assessing a patient with a tracheostomy for the fitting of a tracheostomy speaking valve.
5. An otolaryngologist evaluating a patient with a tracheostomy for the use of a tracheostomy prosthetic to improve speech.
6. A healthcare provider assessing a patient with a laryngectomy for the use of a voice prosthetic device and providing instructions on its proper use.
7. A speech-language pathologist evaluating a patient with a tracheostomy for the fitting of a speaking valve and providing training on its use.
8. An otolaryngologist assessing a patient with a history of laryngeal cancer for the use of an electrolarynx and providing guidance on its use.
9. A healthcare provider evaluating a patient with a tracheostomy for the fitting of a tracheostomy prosthetic and teaching the patient how to care for it.
10. A speech therapist assessing a patient with a laryngectomy for the use of a voice prosthetic device and providing instructions on its maintenance.