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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. These devices are crucial for patients who have difficulty expressing themselves verbally due to various conditions, such as neurological disorders, developmental disabilities, or other speech-related challenges. The evaluation process for prescribing an SGD involves a comprehensive face-to-face assessment conducted by a speech-language pathologist (SLP). During this evaluation, the SLP examines the patient's cognitive and communication abilities to determine the nature and extent of the communication impairment. This assessment includes a thorough review of the patient's current language skills and cognitive capabilities, which are essential for selecting the most appropriate SGD. The SLP will also identify any necessary accessories that may enhance the functionality of the device to better meet the patient's specific needs. For billing purposes, the CPT® code 92607 is used to report the first hour of the evaluation, while CPT® code 92608 is designated for each additional 30 minutes of evaluation time, allowing for a structured approach to documenting the services provided.
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The evaluation for prescription of a speech-generating augmentative and alternative communication device is indicated for patients who exhibit communication impairments due to various underlying conditions. These may include, but are not limited to:
The procedure for evaluating a patient for a speech-generating device involves several key steps, each critical to ensuring an accurate assessment and appropriate device selection.
After the evaluation and selection of the speech-generating device, the patient may require follow-up sessions to ensure proper usage and to provide training on how to operate the device effectively. The SLP may also recommend additional resources or support services to assist the patient in integrating the SGD into their daily communication. Continuous monitoring of the patient's progress and adjustments to the device or its accessories may be necessary to optimize communication outcomes. It is important for the SLP to maintain open communication with the patient and their caregivers to address any challenges that may arise during the implementation of the SGD.
| Short Descr | EX FOR SPEECH DEVICE RX ADDL | Medium Descr | RX SP-GENRATJ AUGMNT&COMUNICAJ DEV EA 30 MIN | Long Descr | 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) | Status Code | Active Code | Global Days | ZZZ - Code Related to Another Service | PC/TC Indicator (26, TC) | 7 - Physical Therapy Service, for which Payment may not be Made | Multiple Procedures (51) | 0 - No payment adjustment rules for multiple procedures apply. | 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 | 4 | CCS Clinical Classification | 220 - Ophthalmologic and otologic diagnosis and treatment |
This is an add-on code that must be used in conjunction with one of these primary codes.
| 92607 | Telehealth Service (Medicare) 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; first hour |
| 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. | CR | Catastrophe/disaster related | 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. | 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) | GO | Services delivered under an outpatient occupational therapy plan of care | GT | Via interactive audio and video telecommunication systems | GW | Service not related to the hospice patient's terminal condition | KX | Requirements specified in the medical policy have been met |
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| 2003-01-01 | Added | First appearance in code book in 2003. |
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