Table of Contents

2018 Coding & Billing for Audiology and Speech-Language Pathology

• • ASHA Disclaimer ii4
  • American Medical Association (AMA) CPT Codes ii4
  • Copyright Page ii4
  • Table of Contents iii5
  • Highlights for 2018 iv6
  • Chapter 1: CPT Codes 19
  • • General 19
    • Use of Codes 19
    • ASHA’s Health Care Economics Committee 19
    • CPT Procedure Codes 19
    • • Special Otorhinolaryngologic Services 19
      • Additional CPT Codes 412
      • Case Management Services 614
  • Chapter 2: ICD-10-CM Diagnosis Codes 1119
  • • General 1119
    • Use of Codes 1119
    • • Overview 1119
      • Scope 1119
      • Purpose 1119
      • Relation to Professional Scope of Practice 1119
      • ICD-10-CM Guidelines 1119
      • Official ICD-10-CM Websites 1220
      • ASHA Resources 1220
    • Codes: Audiology ICD-10-CM 1321
    • ICD-10-CM Tabular List of Diseases and Injuries Related to hearing and vestibular disorders 1321
    • ICD-10-CM Diagnosis Codes: Speech-Language Pathology 4654
    • ICD-10-CM Tabular List of Diseases and Injuries Related to speech, language, and swallowing disorders 4654
    • Coding Normal Results Frequently Asked Questions 8896
    • ICD-10-PCS (Procedure Coding System) for Audiologists and SLPs 8997
  • Chapter 3: Coding Case Scenarios 93101
  • • Audiology Coding Case Scenarios 93101
    • Speech-Language Pathology Coding Case Scenarios 95103
  • Chapter 4: HCPCS (Healthcare Common Procedure Coding System, Medicare & Medicaid) 101109
  • • General 101109
    • Use of Codes 101109
    • Audiology Related HCPCS Codes 101109
    • Speech-Language Pathology Related HCPCS Codes 102110
  • Chapter 5: G-codes 107115
  • • G-codes and Severity Modifiers for Speech-Language Pathology Claims-Based Outcomes Reporting for Medicare Part B Therapy Services 107115
    • • Background 107115
      • Reporting 107115
      • Speech-Language Pathology Related G-codes 108116
      • Severity Modifiers 109117
    • Case Scenarios and Sample Claim Form Entries for Outcomes Reporting for Medicare Part B Therapy Services 110118
  • Chapter 6: Medicare Quality Reporting Requirements 123131
  • Chapter 7: National Correct Coding Initiative (NCCI) Edits 127135
  • • Audiology Procedures 127135
    • Speech-Language Pathology Procedures 129137
  • Chapter 8: ASHA Model Superbills 133141
  • • Model Superbill for Audiology 133141
    • Model Superbill for Speech-Language Pathology 138146
  • Chapter 9: 1500 Claim Form 143151
  • Chapter 10: Fee Data 147155
  • • Introduction 147155
    • Determining Fees 147155
    • Medicare Fee Schedule 147155
    • Milliman Charge Data 147155
    • Alternative Payment Models 159167
  • Chapter 11: Documentation Guidance 163171
  • • Documentation Tips 163171
    • Documentation for Audiology, Based on Medicare Requirements 163171
    • • Documenting Audiological Tests 163171
    • Medicare Documentation forSpeech-Language Pathology 164172
    • • Summary 164172
      • Evaluation 164172
      • Plan of Care/Certification of the Plan of Care 164172
      • Progress Reports 164172
      • CMS Example of a SLP Progress Note 165173
      • Treatment Notes 165173
      • Discharge Note 165173
    • Electronic Health Records 166174
  • Chapter 12: Appendix & Resources 169177
  • • ICD-9-CM Conversion to ICD-10-CM 169177
    • • Audiology 169177
      • Speech-Language Pathology 190198
    • Resources 209217
    • Audiology Most Commonly Used Codes 211219
    • Speech-Language Pathology Most Commonly Used Codes 212220