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The procedure described by CPT® Code 92597 involves a comprehensive evaluation for the use and fitting of a voice prosthetic device, which is designed to enhance oral speech for individuals who may have lost their natural voice due to various medical conditions. This evaluation process is critical as it ensures that the selected voice prosthetic device aligns with the specific needs of the patient. During the evaluation, the healthcare provider assesses various features of the prosthetic device, including the diameter of the body, the thickness and diameter of the esophageal flange, and the length of the esophageal end. These measurements are essential to determine the appropriate size of the prosthesis, ensuring optimal functionality and comfort for the patient. Once the correct size is established, the prosthetic device is ordered. Upon its arrival, the patient returns for a fitting session, where an esophageal retention collar that matches the required diameter is selected, and the prosthesis is inserted. The provider also takes the time to instruct the patient on the proper use and care of the voice prosthetic device, which is vital for its effective use in supplementing oral speech.
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The evaluation for the use and/or fitting of a voice prosthetic device is indicated for patients who require assistance in supplementing their oral speech due to conditions affecting their ability to speak naturally. The following are specific indications for this procedure:
The procedure for evaluating and fitting a voice prosthetic device involves several critical steps to ensure the device meets the patient's specific needs. The first step is a thorough evaluation of the patient's requirements for a voice prosthetic device. This includes assessing the patient's medical history, current speech capabilities, and any previous attempts at using similar devices. Following this assessment, the provider measures key dimensions of the prosthetic device, such as the diameter of the body, the thickness and diameter of the esophageal flange, and the length of the esophageal end. These measurements are crucial for determining the correct size of the prosthesis that will provide the best fit and functionality for the patient. Once the appropriate size is established, the provider orders the prosthetic device. Upon its arrival, the patient is scheduled for a fitting appointment. During this session, the provider selects an esophageal retention collar that matches the required diameter and carefully inserts the prosthesis into the patient's esophagus. Finally, the patient receives detailed instructions on how to use and care for the voice prosthetic device, which is essential for ensuring its effectiveness and longevity.
After the fitting of the voice prosthetic device, the patient is expected to follow specific post-procedure care instructions to ensure proper use and maintenance of the device. This includes regular cleaning of the prosthesis to prevent any buildup of secretions or debris, which could affect its functionality. The patient should also be advised on how to monitor for any signs of discomfort or complications, such as irritation or difficulty in speech. Follow-up appointments may be scheduled to assess the patient's adaptation to the device and to make any necessary adjustments. It is important for the patient to practice using the device regularly to enhance their speech capabilities and to seek assistance from their healthcare provider if they encounter any issues during the adjustment period.
| Short Descr | ORAL SPEECH DEVICE EVAL | Medium Descr | EVAL&/FITG VOICE PROSTC DEV SUPLMNT ORAL SPEEC | Long Descr | Evaluation for use and/or fitting of voice prosthetic device to supplement oral speech | Status Code | Active Code | Global Days | XXX - Global Concept Does Not Apply | PC/TC Indicator (26, TC) | 7 - Physical Therapy Service, for which Payment may not be Made | Multiple Procedures (51) | 5 - Special payment adjustment rules on the RVU practice expense component of multiple therapy service applies... | Bilateral Surgery (50) | 0 - 150% payment adjustment for bilateral procedures does NOT apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 0 - Payment restriction for assistants at surgery applies to this procedure... | Co-Surgeons (62) | 0 - Co-surgeons not permitted for this procedure. | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Service Paid under Fee Schedule or Payment System other than OPPS | Type of Service (TOS) | 1 - Medical Care | Berenson-Eggers TOS (BETOS) | O1F - Hearing and speech services | MUE | 1 | CCS Clinical Classification | 215 - Other physical therapy and rehabilitation |
| GN | Services delivered under an outpatient speech language pathology plan of care | KX | Requirements specified in the medical policy have been met | 58 | Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78. | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | 76 | Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | 95 | Synchronous telemedicine service rendered via a real-time interactive audio and video telecommunications system: synchronous telemedicine service is defined as a real-time interaction between a physician or other qualified health care professional and a patient who is located at a distant site from the physician or other qualified health care professional. the totality of the communication of information exchanged between the physician or other qualified health care professional and the patient during the course of the synchronous telemedicine service must be of an amount and nature that would be sufficient to meet the key components and/or requirements of the same service when rendered via a face-to-face interaction. modifier 95 may only be appended to the services listed in appendix p. appendix p is the list of cpt codes for services that are typically performed face-to-face, but may be rendered via a real-time (synchronous) interactive audio and video telecommunications system. | AQ | Physician providing a service in an unlisted health professional shortage area (hpsa) | GV | Attending physician not employed or paid under arrangement by the patient's hospice provider | GW | Service not related to the hospice patient's terminal condition | GZ | Item or service expected to be denied as not reasonable and necessary | PD | Diagnostic or related non diagnostic item or service provided in a wholly owned or operated entity to a patient who is admitted as an inpatient within 3 days | PN | Non-excepted service provided at an off-campus, outpatient, provider-based department of a hospital | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service |
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| 2003-01-01 | Changed | Code description changed. |
| 1996-01-01 | Added | First appearance in code book in 1996. |
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