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Speech-generating devices (SGD), also known as voice-output communication aids (VOCA), are specialized electronic tools designed to assist individuals with communication impairments by producing synthetic or digital speech. The evaluation process for prescribing such a device is critical and is conducted face-to-face by a qualified speech-language pathologist (SLP). During this evaluation, the SLP assesses the patient's cognitive and communication abilities to determine the nature and extent of their communication impairment. This comprehensive assessment includes a thorough evaluation of the patient's current language skills and cognitive capabilities. The outcome of this evaluation is essential, as it enables the SLP to recommend the most suitable SGD tailored to the patient's specific needs, as well as any necessary accessories that may enhance the device's functionality. The CPT® Code 92607 is specifically designated for billing the first hour of this evaluation process, while subsequent evaluations or additional time spent are reported using CPT® Code 92608, which covers each additional 30 minutes of face-to-face evaluation time.
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The evaluation for a speech-generating augmentative and alternative communication device is indicated for patients who exhibit communication impairments due to various conditions. These may include, but are not limited to, the following:
The procedure for evaluating a patient for a speech-generating device involves several key steps that are crucial for determining the appropriate device and accessories. Each step is designed to gather comprehensive information about the patient's communication needs and capabilities.
After the evaluation, the SLP provides the patient and their caregivers with detailed information regarding the recommended speech-generating device and any accessories. This includes instructions on how to use the device effectively and strategies for integrating it into daily communication. Follow-up appointments may be scheduled to monitor the patient's progress and make any necessary adjustments to the device or communication strategies. It is essential to ensure that the patient is comfortable and proficient in using the device to facilitate effective communication.
| Short Descr | EX FOR SPEECH DEVICE RX 1HR | Medium Descr | RX SP-GENRATJ AUGMNT&COMUNICAJ DEV 1ST HR | Long Descr | Evaluation for prescription for speech-generating augmentative and alternative communication device, face-to-face with the patient; first hour | 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 | 220 - Ophthalmologic and otologic diagnosis and treatment |
This is a primary code that can be used with these additional add-on codes.
| 92608 | Telehealth Service (Medicare) Addon Code MPFS Status: Active Code APC A PUB 100 CPT Assistant Article Evaluation for prescription for speech-generating augmentative and alternative communication device, face-to-face with the patient; each additional 30 minutes (List separately in addition to code for primary procedure) |
| GN | Services delivered under an outpatient speech language pathology plan of care | 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. | KX | Requirements specified in the medical policy have been met | 57 | Decision for surgery: an evaluation and management service that resulted in the initial decision to perform the surgery may be identified by adding modifier 57 to the appropriate level of e/m service. | 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. | 96 | Habilitative services: when a service or procedure that may be either habilitative or rehabilitative in nature is provided for habilitative purposes, the physician or other qualified health care professional may add modifier 96 to the service or procedure code to indicate that the service or procedure provided was a habilitative service. habilitative services help an individual learn skills and functioning for daily living that the individual has not yet developed, and then keep and/or improve those learned skills. habilitative services also help an individual keep, learn, or improve skills and functioning for daily living. | 97 | Rehabilitative services: when a service or procedure that may be either habilitative or rehabilitative in nature is provided for rehabilitative purposes, the physician or other qualified health care professional may add modifier 97 to the service or procedure code to indicate that the service or procedure provided was a rehabilitative service. rehabilitative services help an individual keep, get back, or improve skills and functioning for daily living that have been lost or impaired because the individual was sick, hurt, or disabled. | CC | Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed) | CR | Catastrophe/disaster related |
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| 2011-01-01 | Changed | Short description changed. |
| 2003-01-01 | Added | First appearance in code book in 2003. |
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