Billing and Coding: Home Health Speech-Language Pathology

The information in this article contains billing, coding or other guidelines
that complement the Local Coverage Determination (LCD) for Home Health Speech-
Language Pathology L34563

**Coding Guidelines**  
  
1.When billing for a "Z" code as a diagnosis code, documentation should
include (if applicable) the name of the orthotic/prosthetic device, date the
patient received the device, and the date training/teaching began.  
  
2\. For the purpose of the related LCD, diagnosis code R68.89 should be used
when treating memory disturbances not associated with mental disorders (e.g.,
post cerebrovascular accident (CVA)).  
  
3\. As of July 1999, speech-language pathologist (SLP) must report time spent
with the patient in 15-minute increments. The following code should be used
for SLP:

  * G0153- Speech-Language Pathology

**  *Note:** Other HCPCS codes found in this article are for informational and
descriptive use only.

**Re-evaluation**

  * **Speech/hearing treatment (CPT  92507)**
    * Regarding speech generating devices (SGDs), use CPT 92607 for selection and prescription; use CPT 92609 for adaptation and training.
  * **Note:** Current Procedural Terminology (CPT) does not define a re-evaluation code for Speech-Language Pathology: use the evaluation code.

**Glossary of terms commonly used in Speech Language Pathology**

Amelioration - to make or become better.  
  
Articulation - vocal tract movements for speech sound production; involves
accuracy in placement of the articulators, timing, direction of movements,
force extended, speed or response, and neutral integration of all events.  
  
Audition - the sense or act of hearing.  
  
Compensation - to make up for or offset; counterbalance; making up for a
deficiency or loss.  
  
Fluency - smoothness with which sounds, syllables, words and phrases are
joined together during oral language; lack of hesitations or repetitions in
speaking.  
  
Morphology - study of how morphemes (smallest meaningful unit of a language)
are put together to form words; indicates how words are formed and provides a
bridge between phonology and syntax.  
  
Phonology - study of the sound system of a language, including pauses and
stress.  
  
Pragmatics - study of the rules underlying the functional use of language.  
  
Resonance - sympathetic or forced vibration of the air in the cavities above,
below, in front of, or behind the source of a sound.  
  
Semantics - 1) study of meaning in language which includes the relation
between language, thoughts, and behavior; 2) study of meaning of speech forms,
especially of the development and changes in meaning of words and word groups;
3) study of the development of the meaning of words, its goals is to account
for the knowledge a native speaker has which enables him to judge some
sentences as meaningful, some as ambiguous, and some as anomalous.  
  
Syntax - 1) the internal structure of language including the order in which
the element of a language can occur and the relationships among the elements
in an utterance; 2) rules that dictate the acceptable sequences, combination,
and function of words in a sentence; 3) the way in which words are put
together in a sentence to convey meaning.