How To Use CPT Code 92605

CPT 92605 describes the evaluation for prescription of non-speech-generating augmentative and alternative communication device, conducted face-to-face with the patient for one hour. 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 92605?

CPT 92605 can be used to describe the evaluation conducted by a healthcare provider to assess the patient’s abilities and determine the most suitable non-speech-generating augmentative and alternative communication device. This code represents a one-hour face-to-face service where the provider interacts with the patient and their caregiver to gather information and make recommendations for communication improvement.

2. Official Description

The official description of CPT code 92605 is: ‘Evaluation for prescription of non-speech-generating augmentative and alternative communication device, face-to-face with the patient; first hour.’

3. Procedure

1. The healthcare provider conducts an interview with the patient to assess their visual and auditory abilities.
2. They evaluate the patient’s motor skills and muscle strength to determine their ability to control limbs.
3. The provider tests the patient’s learning ability and communication skills through general questions and observation.
4. They assess the patient’s understanding of symbols and their potential to benefit from non-speech-generating communication devices.
5. The provider interacts with the patient and their family, providing guidance on improving communication and recommending appropriate devices.

4. Qualifying circumstances

CPT 92605 is applicable when a patient requires an evaluation for the prescription of a non-speech-generating augmentative and alternative communication device. The evaluation is conducted face-to-face with the patient for one hour. The provider assesses the patient’s abilities and interacts with their caregiver to gather appropriate feedback.

5. When to use CPT code 92605

CPT code 92605 should be used when a healthcare provider conducts an evaluation for the prescription of a non-speech-generating augmentative and alternative communication device. This code represents the first hour of face-to-face service. If additional evaluation time is required, CPT code 92618 can be used to report each additional 30 minutes.

6. Documentation requirements

To support a claim for CPT 92605, the healthcare provider must document the following information:

• Patient’s abilities and limitations related to communication
• Specific evaluation techniques used
• Date and duration of the face-to-face evaluation
• Recommendations for non-speech-generating augmentative and alternative communication devices
• Interaction with the patient and their caregiver
• Signature of the healthcare provider conducting the evaluation

7. Billing guidelines

When billing for CPT 92605, ensure that the evaluation is conducted face-to-face with the patient for one hour. It is important to follow the guidelines and not report CPT 92605 with other codes unless additional evaluation time is required, in which case CPT 92618 should be used. Remember to provide appropriate documentation to support the claim.

8. Historical information

CPT 92605 was added to the Current Procedural Terminology system on January 1, 2003. The code underwent a change on January 1, 2012, with an updated description for the evaluation of non-speech-generating augmentative and alternative communication devices.

9. Examples

1. A speech-language pathologist conducting an evaluation to determine the most suitable non-speech-generating augmentative and alternative communication device for a patient with cerebral palsy.
2. An occupational therapist assessing a patient with a traumatic brain injury to recommend appropriate non-speech-generating augmentative and alternative communication devices.
3. A neurologist evaluating a patient with amyotrophic lateral sclerosis (ALS) to determine the most effective non-speech-generating augmentative and alternative communication device.
4. A pediatrician conducting an evaluation for a child with autism spectrum disorder to prescribe a non-speech-generating augmentative and alternative communication device.
5. A rehabilitation specialist assessing a stroke survivor’s communication abilities to recommend suitable non-speech-generating augmentative and alternative communication devices.
6. A physical therapist evaluating a patient with multiple sclerosis to determine the most appropriate non-speech-generating augmentative and alternative communication device.
7. A developmental psychologist conducting an evaluation for a child with Down syndrome to prescribe a non-speech-generating augmentative and alternative communication device.
8. A geriatrician assessing an elderly patient with dementia to recommend appropriate non-speech-generating augmentative and alternative communication devices.
9. A special education teacher evaluating a student with a learning disability to determine the most suitable non-speech-generating augmentative and alternative communication device.
10. A neuropsychologist conducting an evaluation for a patient with a brain tumor to prescribe a non-speech-generating augmentative and alternative communication device.