Survey Finds Coding Problems in Reimbursement for Voice Treatment A recent reimbursement survey of the members of Special Interest Division 3, Voice and Voice Disorders, reveals that some clinic practices inhibit speech-language pathologists’ mastery of insurance coding rules and realization of appropriate reimbursement for the services provided. This information was revealed in results of a 2006 survey of division ... Bottom Line
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Bottom Line  |   April 01, 2007
Survey Finds Coding Problems in Reimbursement for Voice Treatment
Author Notes
  • Mark Kander, is director of health care regulatory analysis. Contact him at mkander@asha.org.
    Mark Kander, is director of health care regulatory analysis. Contact him at mkander@asha.org.×
Article Information
Speech, Voice & Prosodic Disorders / Voice Disorders / Practice Management / Bottom Line
Bottom Line   |   April 01, 2007
Survey Finds Coding Problems in Reimbursement for Voice Treatment
The ASHA Leader, April 2007, Vol. 12, 3-29. doi:10.1044/leader.BML.12052007.3
The ASHA Leader, April 2007, Vol. 12, 3-29. doi:10.1044/leader.BML.12052007.3
A recent reimbursement survey of the members of Special Interest Division 3, Voice and Voice Disorders, reveals that some clinic practices inhibit speech-language pathologists’ mastery of insurance coding rules and realization of appropriate reimbursement for the services provided.
This information was revealed in results of a 2006 survey of division members that focused on proper coding and reimbursement for assessment and treatment of voice and upper airway disorders. The reimbursement committee, chaired by Edie Hapner, found that more than 30% of the respondents usually did not see the American Medical Association’s Current Procedural Terminology© (CPT) codes or diagnosis codes entered on insurance claim forms.
More than 50% of respondents indicated that they infrequently or never received information regarding denials for services provided. Of those performing videostroboscopies (CPT 31579), more than 15% were submitting inaccurate CPT codes. For repeat videostroboscopies, approximately 30% of the respondents indicated erroneous codes. Another area of problematic reimbursement involves acoustic and aerodynamic testing (CPT 92520), also known as laryngeal function tests. The survey revealed these were usually coded as speech-language-communication evaluations or treatment, rather than as the specific code for this instrumental assessment.
Committee members Dee Nikjeh, Sandy Schwartz, and Mary Sandage met in early March, joined by a member of ASHA’s Health Care Economics and Advocacy Team, to analyze trends and identify common billing mistakes. The goals were to draft publication language clarifying coding rules and to create a routine forum that will continue educating affiliates about coding and reimbursement.
The scope of coverage by third-party payers can often be just as important as correct coding knowledge. The committee determined that for endoscopic and other instrumental assessments, members must clearly understand the rules for physician supervision, which may vary according to provider setting and/or payer.
The committee also discussed the American Academy of Otolaryngology-Head and Neck Surgery’s (AAO-HNS) decision to veto ASHA’s 2006 request to the National Correct Coding Initiative (NCCI) to allow billing for a diagnostic laryngoscopy (CPT 31575) on the same day as a videostroboscopy (CPT 31579). The committee was confident it could identify otolaryngologists who could articulate to AAO-HNS the reasons for allowing the diagnostic procedures to be performed on the same day. Physician letters of support will be presented to AAO-HNS as a precursor to a repeat request to NCCI, coordinated by ASHA’s Health Care Economics Committee (HCEC).
Another action item identified was the need to remove “hypernasality” from the International Classification of Diseases, 9th Revision (ICD-9) code 784.49.
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April 2007
Volume 12, Issue 5