Device Documentation Follow these guidelines when documenting and billing for speech-generating device evaluation and treatment. Bottom Line
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Bottom Line  |   February 01, 2018
Device Documentation
Author Notes
  • Neela Swanson is director of ASHA health care coding policy and advocacy. nswanson@asha.org
    Neela Swanson is director of ASHA health care coding policy and advocacy. nswanson@asha.org×
  • Tim Nanof, MSW, is director of ASHA health care policy and advocacy. tnanof@asha.org
    Tim Nanof, MSW, is director of ASHA health care policy and advocacy. tnanof@asha.org×
Article Information
Augmentative & Alternative Communication / Practice Management / Bottom Line
Bottom Line   |   February 01, 2018
Device Documentation
The ASHA Leader, February 2018, Vol. 23, 32-33. doi:10.1044/leader.BML.23022018.32
The ASHA Leader, February 2018, Vol. 23, 32-33. doi:10.1044/leader.BML.23022018.32
Securing insurance approval for a speech-generating device (SGD) can be a complex process for speech-language pathologists, involving extensive paperwork requirements and coordination with physicians, manufacturers and durable medical equipment suppliers. Specialized resources or tools, such as documentation checklists or evaluation templates, can streamline documentation and payer-report preparation.
However, these tools do not replace the clinical judgment of the SLP, who is ultimately responsible for accurate billing and documentation to justify the need for an SGD.
Here are a few things to keep in mind when seeking approval for a client’s SGD.
What documentation should I submit to justify the purchase of an SGD?
SLPs should always check with the payer directly, as requirements can vary from payer to payer. SGD manufacturers may also help track payer requirements, though the SLP (the clinician of record) is ultimately responsible for fulfilling the requirements.
Medicare requirements are a good general guide. In most cases, SLPs must document a comprehensive augmentative and alternative communication (AAC) evaluation and provide a written report that addresses the patient’s individual communication needs, recommends the most appropriate device, and determines software and/or accessories needed.
Can SLPs use resources like ASHA’s SGD evaluation template to facilitate and support clinical evaluations?
Clinicians can certainly use evaluation templates from ASHA and other entities for guidance. These resources can help ensure that you include key elements that support appropriate access, coverage and payment.
These resources, however, should not replace individualized recommendations based on the clinical knowledge and expertise of the evaluating and treating clinician. The SLP holds the responsibility for the individualized evaluation and appropriate documentation of the medical necessity of the device as well as the specific clinical details that guide device selection.
It is never appropriate or ethical to submit a standardized report that is not a result of an individualized assessment, or to submit a claim for reimbursement that was not performed by the clinician of record.
What Current Procedural Terminology (CPT,® American Medical Association) codes should the SLP report for an SGD evaluation?
CPT code 92607 is used to report the first hour of an SGD evaluation. CPT code 92608 allows the SLP to bill for each additional 30 minutes of the evaluation. Because CPT codes 92607 and 92608 are timed and may be billed in multiple units, you should document how long the evaluation took and bill the appropriate number of units according to reporting guidelines for timed codes.

It is never appropriate or ethical to submit a standardized report that is not a result of an individualized assessment or to submit a claim for reimbursement that was not performed by the clinician of record.

How are programming, modification and training in the use of the SGD reported?
CPT 92609 should be used to report therapeutic services for SGD use. CPT 92609 is an untimed code, meaning that it can be reported only once per day, regardless of the length of the session.
What is the standard Medicare reimbursement rate for 2018 SGD evaluation and treatment codes?
The 2018 national rate for CPT 92607 (SGD evaluation, first hour) is $133.56. CPT 92608 (the 30-minute code for evaluations beyond 60 minutes) is valued at $53.64.
The 2018 national rate for CPT code 92609 (therapeutic services for the use of SGD) is $111.96 per session.
The rates may vary by locality. Information on the 2018 Medicare national rates for all speech-language pathology services is available on the ASHA website.
What codes are used to report the SGDs themselves?
The following Healthcare Common Procedures Coding System (HCPCS) Level II codes describe various types of speech-generating equipment. Differentiating factors include type (device or accessory), speech (digitized or synthesized) and length of recording.
  • E2500, Speech-generating device, digitized speech, using pre-recorded messages, less than or equal to 8 minutes recording time.

  • E2502, Speech-generating device, digitized speech, using pre-recorded messages, greater than 8 minutes but less than or equal to 20 minutes recording time.

  • E2504, Speech-generating device, digitized speech, using pre-recorded messages, greater than 20 minutes but less than or equal to 40 minutes recording time.

  • E2506, Speech-generating device, digitized speech, using pre-recorded messages, greater than 40 minutes recording time.

  • E2508, Speech-generating device, synthesized speech, requiring message formulation by spelling and access by physical contact with the device.

  • E2510, Speech-generating device, synthesized speech, permitting multiple methods of message formulation and multiple methods of device access.

  • E2511, Speech-generating software program, for personal computer or personal digital assistant.

  • E2512, Accessory for speech-generating device, mounting system.

  • E2599, Accessory for speech-generating device, not otherwise specified.

Are SLPs responsible for submitting claims for the devices?
Generally, no. Submit claims for the time you spend in evaluation and treatment, but work directly with the payer-approved SGD manufacturer or durable medical equipment supplier to procure the device. Payers reimburse the supplier directly for the device.
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February 2018
Volume 23, Issue 2