Article - Billing and Coding: Home Health Speech-Language Pathology (A53052)

CMS National Coverage PolicyTitle XVIII of the Social Security Act, 1833(e) prohibits Medicare payment for any claim lacking the necessary documentation to process the claim.Title XVIII of the Social Security Act, 1835(a)(2)(A) addresses procedure for payment of claims of providers of services.CMS Internet-Only Manual, Pub. 100-04, Medicare Claims Processing Manual, Chapter 5, 20 HCPCS Coding Requirement, 20.1 Discipline Specific Outpatient Rehabilitation Modifiers - All Claims, and 20.2 Reporting of Service Units With HCPCSCMS Internet-Only Manual, Pub. 100-08, Medicare Program Integrity Manual, Chapter 6, 6.2.4 CodingArticle TextThe information in this article contains billing, coding or other guidelines that complement the Local Coverage Determination (LCD) for Home Health Speech-Language Pathology L34563Coding Guidelines1.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 thisarticleare for informational and descriptive use only.Re-evaluationSpeech/hearing treatment (CPT92507)Regardingspeech generating devices (SGDs), use CPT92607 for selection and prescription; use CPT92609 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 PathologyAmelioration  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.