New and Revised CPT Codes for 2006 Q: Are there new CPT codes in 2006 for speech-language pathology and audiology services? Yes. New Current Procedural Terminology (CPT®) codes became effective on Jan. 1. The revisions to the acoustic reflex testing code and addition of the auditory rehabilitation codes are the result of the work of the ASHA ... Bottom Line
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Bottom Line  |   February 01, 2006
New and Revised CPT Codes for 2006
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Speech, Voice & Prosodic Disorders / Hearing Disorders / Audiologic / Aural Rehabilitation / Bottom Line
Bottom Line   |   February 01, 2006
New and Revised CPT Codes for 2006
The ASHA Leader, February 2006, Vol. 11, 3-38. doi:10.1044/leader.BML.11022006.3
The ASHA Leader, February 2006, Vol. 11, 3-38. doi:10.1044/leader.BML.11022006.3
Q: Are there new CPT codes in 2006 for speech-language pathology and audiology services?
Yes. New Current Procedural Terminology (CPT®) codes became effective on Jan. 1. The revisions to the acoustic reflex testing code and addition of the auditory rehabilitation codes are the result of the work of the ASHA Health Care Economics Committee (HCEC). The committee submits recommendations to the American Medical Association’s CPT Editorial Committee after collaborating with the audiology community, the speech-language pathology community, and the otolaryngology community.
Q: What specific CPT procedures and codes took effect on Jan. 1?
The descriptors for the CPT codes added in 2006 are:
  • 92626: Evaluation of auditory rehabilitation status; first hour

  • +92627: each additional 15 minutes (List separately in addition to code for primary procedure)

  • 92630: Auditory rehabilitation; pre-lingual hearing loss

  • 92633: Auditory rehabilitation; post-lingual hearing loss

Q: What values has Medicare assigned these new procedures?
The Centers for Medicare and Medicaid Services (CMS) has incorrectly valued the auditory rehabilitation assessment procedures, pricing one hour at the same rate as each additional 15 minutes ($22). At press time, ASHA received reports that the values published in the final rule will be revised. ASHA has been negotiating with CMS for the use of comparable procedures to establish the values. Audiologists need to know that 92630 and 92633 are not covered by Medicare because they are seen as audiology treatment procedures and the Medicare program limits coverage to diagnostic testing. CMS specified that SLPs providing auditory rehabilitation treatment should use CPT 92507.
We suggest that SLPs use 92506 for evaluation of auditory rehabilitation status rather than 92626 and 92627 if CMS views the new procedures as audiologic.
Q: What has happened to the descriptors of 92506 and 92507? Don’t they include aural rehabilitation?
The descriptors have been revised for 2006 to eliminate reference to aural rehabilitation. The descriptors now read as follows:
  • 92506: Evaluation of speech, language, voice, communication, and/or auditory processing

  • 92507: Treatment of speech, language, voice, communication, and/or auditory processing disorder

Q: I heard that the acoustic reflex testing descriptor has changed. Is that true?
Yes. The HCEC knew that health plans were denying payment of acoustic reflex decay, claiming that it was part of the acoustic reflex testing code. CPT 92568 now reads: “Acoustic reflex testing; threshold.” The new descriptor clarifies that the code is for acoustic reflex threshold testing only, and that testing for decay is a separate procedure.
Q: Are there changes that ASHA is concerned about?
Yes. CPT 96115 is replaced by new 96116 with the same descriptor except for the added phrase, “per hour of the psychologist’s or physician’s time.” Thus SLPs must use 92506 for cognitive-communicative evaluations. The HCEC has already secured support of the American Psychological Association for elimination of the last phrase which had been added late in the approval process by the CPT Editorial Panel. However, the lead time for CPT revisions is two years.
Q: Who can I contact if I have any further questions about the CPT coding changes?
You can e-mail reimbursement@asha.org and your questions will be answered within 24 hours during the week.
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February 2006
Volume 11, Issue 2