AMA Coding Changes Help Clinicians Reimbursement Gains Result From Efforts by ASHA Committee Members Bottom Line
Bottom Line  |   November 01, 2005
AMA Coding Changes Help Clinicians
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Practice Management / ASHA News & Member Stories / Bottom Line
Bottom Line   |   November 01, 2005
AMA Coding Changes Help Clinicians
The ASHA Leader, November 2005, Vol. 10, 3. doi:10.1044/leader.BML.10162005.3
The ASHA Leader, November 2005, Vol. 10, 3. doi:10.1044/leader.BML.10162005.3
These reimbursement gains are the culmination of two years’ work by the ASHA Health Care Economics Committee (HCEC) and the HCEC members who serve as ASHA’s advisors to AMA coding groups. Those advisors are Wayne Holland, an SLP who represents ASHA on the AMA CPT Editorial Panel, and Robert Fifer, an audiologist on the HCEC who serves on the AMA Relative Value Update Committee.
Coding Changes
The four new procedures for reporting auditory rehabilitation are as follows:
  • 92626, “Evaluation of auditory rehabilitation status; first hour.”

  • 92627, for “Evaluation of auditory rehabilitation status; each additional 15 minutes.”

  • 92630, “Auditory rehabilitation; pre-lingual hearing loss.”

  • 92633, “Auditory rehabilitation; post-lingual hearing loss.”

These new codes created a need to revise the descriptors of two long-standing codes—92506 and 92507. Reference to aural rehabilitation in both of those procedures is deleted for 2006. CPT 92506 will read, “Evaluation of speech, language, voice, communication, and/or auditory processing,” and CPT 92507 will be “Treatment of speech, language, voice, communication, and/or auditory processing disorder; individual.”
Medicare, however, still views auditory rehabilitation as diagnostic procedures, and does not reimburse audiologists and SLPs for those services.
Another new and more specific descriptor—92568, “Acoustic reflex testing: threshold”—should resolve problems with current codes 92568 and 92569. Audiologists had reported problems with 92568, “Acoustic reflex testing” and 92569, “Acoustic reflex decay.” Third party payers denied reimbursement for 92569, stating that it was bundled in 92568, and maintained that position when contacted by ASHA and audiologists. The new 92568 descriptor should resolve the payers’ misinterpretation by making clear that the code relates specifically to establishing a threshold.
SLPs who evaluate and treat patients with voice disorders will benefit from the AMA’s change in CPT 92520, which will describe more specifically what is involved with laryngeal function studies. The new 92520 descriptor will read: “Laryngeal function studies (i.e., aerodynamic testing and acoustic testing)” and note that 92520 is restricted to reporting either aerodynamic testing or acoustic testing.
“The speech-language pathology code changes more precisely describe what is done by the SLP in the three codes that appear in 2006. It’s important to remember that those of us who work with the AMA in its coding process always work in the future,” said Wayne Holland, who represents ASHA on the AMA’s CPT Editorial Panel. “We’re now focusing on the 2007 CPT code set, and we’ll be calling on members for input as this process continues.”
CPT 2006 is available from the AMA and can be ordered from the AMA Web site. The 2006 edition of ASHA’s Coding and Claims Guide will reflect the changes.
For more information contact Steven White, director of health care economics and advocacy, by phone at 800-498-2071, ext. 4126, or by e-mail at
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November 2005
Volume 10, Issue 16