20 March

Implementing CPT Codes

Speech language pathologists are currently utilizing current procedural terminology or "CPT" codes when dealing with their billing. These codes are primarily service-based and timebased as well. Current codes however aren't perfect and have limitations as well as a few problems, especially where auditory experts are concerned. Currently speech language pathologists can bill for the first hour of evaluation, the first 30 minutes of an STD evaluation, and aphasia evaluations. Of course they can also utilize codes for 15 minutes of oral rehabilitation but all other codes are procedure based and don't give professionals the ability to mark specific times.

Whereas in years past some payers would pay speech language pathologists in increments of 15 minutes newer CPT codes now allow medical professionals to implement payment policies that are based on much stricter and defined CPT codes. Newer codes no longer indicate time frames but rather a typical session type or evaluation type. This allows professionals to comply with the new coding guidelines of the American Medical Association and be more accurate in their billing. These changes/new codes are designed to help both providers and payers with the changing billing policies, auditing, and revisions that are always present in the world of healthcare.

As with any changes in the fields of healthcare/medicine ASHA encourages speech language pathologists to be proactive in their approach to these new codes, especially when there are no time components associated with the codes that they need to use. Learning what these new codes are and how to use them properly can help a practice and any individual medical professional stay on top of their billing and avoid the headaches that come along with learning these codes on-the-fly and/or using improper codes.

Audiology Billing

Written by Jonathan S. Gerber RN MBA

Is the Founder & CEO of The MEDCOR Group. He has over 35 years of experience in the healthcare arena ranging from hands-on clinical to executive level operations. Mr. Gerber has provided administrative support and advice to hospitals, MSO’s, medical groups, IPA’s, health plans and individual physician practices for more than 20 years. As the CEO of several healthcare related companies he improved operational efficiency and productivity, setting best practice benchmarks while meeting client needs. Mr. Gerber received his BSN from Arizona State University and MBA from USC.

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