The American Speech-Language Hearing Association (ASHA) just posted critical information and instruction on the sunsetting code 92506 and its replacements, as well as what to expect with new coding guidelines starting Jan. 1, 2014. With this date just around the corner, there will need to be some charge master discussion, education for staff and newly formalized policies for when to use these now more well-defined evaluation procedures.
Per ASHA, “(CPT, ©American Medical Association) code 92506 (Evaluation of speech, language, voice, communication, and/or auditory processing) will be deleted and replaced with four new, more specific evaluation codes
The new codes are:
- 92521 Evaluation of speech fluency (e.g., stuttering, cluttering)
- 92522 Evaluation of speech sound production (e.g., articulation, phonological process, apraxia, dysarthria)
- 92523 Evaluation of speech sound production (e.g., articulation, phonological process, apraxia, dysarthria); with evaluation of language comprehension and expression (e.g., receptive and expressive language)
- 92524 Behavioral and qualitative analysis of voice and resonance”
At first glance, it is well apparent that more definitive information will be enabled for gathering evaluation specificity for specific patient populations treated.
Overall, since these services are considered more specific subsets of the original code, it is expected that reimbursement will be less than the comprehensive 92506 code. Since CCI edits have not yet been addressed or published by CMS, ASHA officials will keep a vigilante eye on all new publications and instructions that may impact the use of these codes on the same treatment day.
As ASHA still believes there could be relevant use for the 92605 code, they have provided that feedback to CMS and are awaiting a final decision.
As with all other minor changes, the overall impact is rarely fully anticipated. Since the 92506 code was a code that required reporting of a G-code, I personally would anticipate that several of the Medlearn Matters and Change Requests documents published by CMS will need updated. Specifically, MM8005, MM4226 and SE1307 would be a few ones that would require additional clarification when the 92506 may no longer be applicable. Since I have seen no instruction yet on this specific topic, I will drop a note to the FAQ section of CMS – G codes instruction to see if something can be addressed soon.