Perspectives on Voice and Voice Disorders

Coordinator's Corner

Sandage, M. — 2008-03-01

World Voice Day: April 16th, 2008: "Let Your Voice Be Heard"

Johns, M. M. — 2008-03-01

Dollars $$ Sense

Nikjeh, D. A. — 2008-03-01

Coding for Evaluation and Treatment

Kander, M., White, S. — 2008-03-01

This article explains the development and use of ICD-9-CM diagnosis codes, CPT procedure codes, and HCPCS supply/device codes. Examples of appropriate coding combinations, and Coding rules adopted by most third party payers are given. Additionally, references for complete code lists on the Web and a list of voice-related CPT code edits are included. The reader is given adequate information to report an evaluation or treatment session with accurate diagnosis, procedure, and supply/device codes. Speech-language pathologists can accurately code services when given adequate resources and rules and are encouraged to insert relevant codes in the medical record rather than depend on billing personnel to accurately provide this information. Consultation is available from the Division 3 Reimbursement Committee members and from reimbursement@asha.org.

Current Procedural Terminology: Where and How Do We Get CPT Codes?

Fifer, R. C., Nikjeh, D. A. — 2008-03-01

This tutorial provides the background and rationale for the establishment of the Current Procedural Terminology (CPT) Manual as well as instructions for its beneficial use. Current Procedure Terminology selection procedure is contingent upon finding the code descriptor that describes precisely what is performed. Guidelines and procedures for CPT code development and the process for valuation of new CPT codes are discussed. Also included in this tutorial is a brief discussion of the documentation requirements to justify and support the particular codes that were selected.

Health Plan Denials and Appeals

Schwartz, S., McCarty, J. — 2008-03-01

Challenging health plan denials for voice treatment through appeals or advocacy efforts can pay off. This article describes the process of obtaining authorization for voice therapy, filing claims, establishing goals, preparing needed documentation, appealing claims through various levels including independent review, and developing an advocacy campaign if coverage is not offered or is very limited.

Documentation That Works

Hapner, E. R. — 2008-03-01

Clinical documentation allows the speech-language pathologist to chart the events, findings, and clinical impressions gleamed from the patient encounter. Good record keeping enhances clinical follow through with the transfer of information from evaluation findings to therapeutic invention or from session to session to ensure the progression of therapy. Poor record keeping poses a threat to evaluation and therapy follow-through, to insurance reimbursement, and to the development of a clinical record that meets legal standards. The purpose of this article is to provide a streamlined reference for those documenting voice evaluations and therapy encounters. Clinical documentation meeting the guidelines proposed by ASHA (1994, 2006, 2007a), and with regard to Medicare requirements for the documentation of evaluation, plan of care, treatment note, progress note, and discharge note is presented. The use of templates to reduce documentation load is discussed as is the advent of electronic medical record. Documentation can be overwhelming and the amount of information required in documentation of a single therapy session seems to increase each year. Assuring that documents meet medical/legal guidelines and individual payer guidelines is paramount. ASHA resources for assisting clinicians in the development of documentation are highlighted in the article.

ASHA's Documentation Initiative

Brown, J. — 2008-03-01

This article describes the various audiences of documentation for both clinical and reimbursement purposes and the challenges of developing documentation formats that can meet all those needs. The benefits and limitations of electronic medical record systems are discussed. The American Speech-Language-Hearing Association's Working Group on Documentation's current initiative to develop documentation templates is described, and ASHA Web-based resources are included for reference.

An Overview of the Division 3 Reimbursement Committee and the 2006 Reimbursement Survey

Sandage, M. J., Schwartz, S., Hapner, E. R. — 2008-03-01

It became apparent in 2006 from communication with affiliates and from posts to the Division 3 listserv that clinicians treating disorders of voice/upper airway and resonance were in need of correct coding information and a resource to ask billing and coding questions. The Division 3 Steering Committee sought affiliates with knowledge of correct coding and reimbursement specific to the treatment of voice disorders. A Reimbursement Committee was selected and charged with the task of determining affiliate knowledge. Methods: A 39-item multiple choice survey was distributed online via SurveyMonkey. Participants were recruited from the Division 3 e-mail list. Results: A total of 324 affiliates responded, providing a 24 % response rate. Survey information regarding the demographics, practice settings, practice parameters, and coding knowledge is presented. Discussion: Affiliates are treating voice disorders through the lifespan therefore information on billing for voice and other upper aero digestive problems from pediatrics through geriatrics is an important goal for the newly created reimbursement committee. There is a need to assist affiliates with correct coding information, documentation to meet guidelines and maximize reimbursement, and support for affiliate questions that guarantees dissemination of correct, up-to-date information from reimbursement expects.