By Leo John
Are you a speech therapy medical professional? Else, just starting your own speech therapy practice? If so, is your healthcare practice up to date on recent changes in speech therapy billing codes? Whether your answer is yes or no, no worries, as speech therapy billing codes transform all the time. There are many CPT (Current Procedural Terminology) codes to choose from, and most of them are similar. For your speech therapy billing, it’s important to have a thorough knowledge of speech therapy billing codes. Choosing the right CPT code ensures you get reimbursed accurately for the services provided. It also reduces the chance of denials that require resubmission. In this blog, we will explore the most common CPT codes for speech therapy medical billing that you’re likely to encounter regularly in your practice.
What Is Speech Therapy Billing
The American Academy of Professional Coders (AAPC) describes Speech-Language Pathology (SLP) as the therapeutic intervention to recover and strengthen speech skills. According to the American Speech-Language-Hearing Association (ASHA), children aged between 3 and 17 years suffer from speech impairment, communication, language, or swallowing issues. Speech-Language Pathologists provide individualized treatment for those conditions. As SLPS focus on their patient’s care, outsourced speech therapy billing is a valuable strategy to ensure the accurate use of audiology and speech therapy billing codes to obtain appropriate reimbursement for the services provided.
What Is A CPT Code?
CPT (Current Procedural Terminology) codes are a set of medical billing codes that are used to describe medical, diagnostic, and surgical procedures and services. The American Medical Association formed CPT codes as a standard way of representing healthcare services. The panel regularly reviews and updates the CPT codes to accurately represent generating medical advances. CPT codes are used in a variety of cases, including medical billing.
Speech Therapy Medical Billing And Coding
Choosing the correct CPT codes will ensure that your speech therapy practice always receives proper reimbursement for services provided. Here are some medical billing and coding for speech therapists and Speech-Language Pathologists. We will examine the most used CPT codes and modifiers.
Speech, Language, Voice, And Cognition Codes
- 92507 – Evaluation of voice, speech, communication, language, and auditory processing disorder.
- 92520 – Laryngeal function studies.
- 92521 – Evaluation of speech fluency (e.g., Cluttering, stuttering).
- 92522 – Evaluation of speech sound production.
- 92523 – Evaluation of speech sound production (e.g., Phonological process, articulation, apraxia, dysarthria), language comprehension and expression (e.g., Receptive and expressive language).
- 92524 – Behavioral and qualitative research of voice and resonance.
- 92526 – Treatment for swallowing dysfunction or oral function for feeding.
- 97129 – Therapeutic interventions that focus on cognitive function (e.g., Attention, reasoning, memory, executive function, problem-solving, or pragmatic functioning) and compensatory strategies to manage activity (e.g., Managing time or schedules, organizing, initiating, and sequencing tasks), direct (one-on-one) patient contact.
- 97130 – Each additional 15 minutes of therapy, when appropriate.
- 97533 – Sensory integrative strategies to increase sensory processing and enable adaptive responses to environmental conditions.
- 92606 – Therapeutic service offered for the use of non-speech generating device, including programming and modification.
- 92609 – Therapeutic service provided for the use of speech-generating device, including programming and modification.
- 31575 – Laryngoscopy (flexible; diagnostic).
- 31579 – Laryngoscopy (flexible or rigid telescopic, with stroboscope).
- 92610 – Oral and pharyngeal swallowing function evaluation.
- 92611 – Motion fluoroscopic swallowing function by cine or video recording.
- 92612 – Flexible endoscopic swallowing by cine or video recording.
Best Practices For Getting Reimbursed Quickly
When submitting claims for medical billing and coding, there are some best practices you can consider:
CPT Modifiers In Speech Therapy Medical Billing
Modifiers are used in speech therapy medical billing to indicate that a service performed has been modified by some specific case. The following are the speech therapy billing modifiers:
Modifier GN: When Medicare services are provided under plans of care for speech therapy billing.
Modifier KX: When the therapist attests that services at and above the therapy caps are medically required and reasonable, and justification is documented in the patient’s record.
Modifier 22: When the speech therapy physician believes the work needed to provide a service is substantially more than typically required.
Modifier 52: When a procedure or service is partially reduced or eliminated at the physician’s preference.
Modifier 59: To identify services other than E/M services, which are typically not reported together but are reasonable under the circumstances.
There are also limitations on specific CPT code pairs billed on the same day. For these, the medical coding billers should refer to the national Correct Coding Initiative (CCI) edits. The healthcare providers must also note that speech therapy billing is covered in most Medicare part B and commercial insurance.
There are additional medical billing and coding guidelines and instances of medical necessity summarized in the listings of Local Coverage Determinations (LCDs) and National Coverage Determinations (NCDs).
Keep Your Speech Therapy Medical Billing Seamless With MHRCM
We have covered information on speech therapy billing codes. Healthcare providers must comply with documentation, fully explain the medical services rendered, and submit clean claims to the insurance companies. Ultimately, accurate medical billing and coding are the main aspects of keeping your practice healthy and getting reimbursed correctly and in a timely manner. If you’re not sure about ICD-10 and CPT coding, you have many other options. You can hire or outsource medical coding experts from our MHRCM. Contact our MHRCM speech therapy billing codes experts today.
FAQ
What Is The Medical Coding For Speech Therapy Billing?
The medical code for speech therapy billing is 92507. This code is employed to treat speech, voice, language, communication, and/or auditory processing.
How Can MHRCM Support Healthcare Organizations And Speech Therapy Billing Practices?
MHRCM is a leading medical billing and coding company dedicated to providing expert speech therapy billing services in medical billing and coding. Our MHRCM is here to support you, whether you’re managing speech therapy billing services or need assistance with speech therapy billing codes.
What Is The GN Modifier For Speech Therapy Billing?
The GN modifier in speech therapy billing is used to indicate that speech therapy services are provided under care for speech-language pathology. This modifier ensures that the services are billed correctly in the accurate plan.
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