Changes Services must be documented on the current IEP for meetings held prior to August 1 2015 Services must be documented on Service Care Plan for IEP meetings held after August 1 2015 As of August 1 2015 Speech specific ID: 914693
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Slide1
Medicaid Billing Module
Speech Therapy Billing Form
Slide2Changes
Services must be documented on the current IEP for meetings held prior to August 1, 2015.
Services must be documented on Service Care Plan for IEP meetings held after August 1, 2015.
As of August 1, 2015 Speech specific
ICD
d
iagnosis
codes are required
. ICD-9 codes are in effect through September 30, 2015.
ICD codes must relate to the specific type of therapy being provided. A global code such as Autism would not be sufficient
.
As of October 1, 2015 Speech specific ICD-10
d
iagnosis codes are required.
Slide3ICD 10 Diagnosis Codes
Typically Used for Speech Services
This is not a complete list of ICD 10 codes. These are the most frequently codes used by speech therapists. If there are additional codes you need to use, send this information to Terry Riley at the e-mail on the last page.
F80.0
Phonological
disorder (Articulation)
F80.1
Expressive language disorder
F80.2
Mixed receptive-expressive language disorder
F80.4
Speech and language development delay due to hearing
loss
Slide4ICD 10 Diagnosis Codes for Speech Services Continued
F80.81
Childhood onset fluency disorder
F80.89
Other developmental disorders of speech and language
F80.9
Developmental disorder of speech and language,
unspecified
Slide5ICD 10 Diagnosis Codes for Speech Services Continued
Q38.3 Other congenital malformations of tongue (tongue thrust)
R13.0
Aphagia
R13.10 Dysphagia, unspecified
R13.11 Dysphagia, oral phase
R13.19 Other dysphagia
Slide6ICD 10 Diagnosis Codes for Speech Services Continued
R47.01 Aphasia
R47.02 Dysphasia
R47.1 Dysarthria and anarthria
R47.8 Slurred Speech
R47.82 Fluency Disorder in conditions classified elsewhere
Slide7ICD 10 Diagnosis Codes for Speech Services Continued
R49.0 Dysphonia (Hoarseness)
R49.1
Aphonia
(Loss of Voice)
R49.21
Hypernasality
R49.22
Hyponasality
R49.8 Other voice and resonance disorders
R62.0 Delayed milestone in childhood
Slide8Physician Authorization
Physician Authorization is still required annually to bill for
s
peech services.
Authorization can now be from a Physician's Assistant or an Advanced Practice Registered Nurse (APRN).
Authorization is good for one calendar year from the date signed.
ICD10 codes assigned by therapist are placed on authorization form. Physician is confirming those diagnosis codes when signing.
Slide9Student Demographics
Complete this section taking note of the following issues
The diagnosis code is to be an ICD 10 code that matches the need for speech therapy and service(s) being provided.
For provider name print the name of the person providing the service.
Slide10Student Demographics Sample
Medicaid Number
Last Name
First Name
00000000000
Doe
Jane
WVEIS Number
Diagnosis Code
Date of Birth
999999999
F802
01-01-1900
County
School
Provider Name
059
203
Slide11Procedure Codes
Complete date of service and number of units under the appropriate heading for each day of therapy/evaluation.
There are two columns for individual therapy and group therapy.
If the Service was provided through Telehealth add GT to the date’s service.
Slide12Procedures
# 92507
Dates of Service/units
# 92507
Dates of Service/units
# 92508
Date of Service/Units
# 92508
Date of Service/units
#92521
Date of Service
#92522
Date of Service
#92523
Date of Service
#92524
Date of Service
#92561
Date of Service
#92567
Date of Service
8-17-15
/2
8-19-15 / 2 8-24-15 /2 #92570 Date of Service#92583Date of Service#92592 Date of Service#92593Date of Service 8-31-15 /2
Slide13Explanation of Procedures
and Caps
Code
Procedure
Service Unit
92507
Treatment of speech language, voice, communication, and/or auditory processing disorder (includes aural rehabilitation); Individual therapy session
16 units per month at 15 minutes per unit
92508
Treatment of speech language, voice, communication, and/or auditory processing disorder (includes aural rehabilitation); Group, two or more individuals
16 units per month at 15 minutes per unit
92521
Evaluation of speech fluency (e.g., stuttering, cluttering)
1 per calendar year
92522*
Evaluation of speech sound production (e.g., articulation, phonological process, apraxia, dysarthria)
1 per calendar year
92523*
Evaluation of speech production (e.g., articulation, phonological process, apraxia, dysarthria); with evaluation of language comprehension and expression (e.g., receptive and expressive language)
1 per calendar year
92524
Behavioral and qualitative analysis of voice and resonance
1 per calendar year
92561
Beskey Diagnostic1 per calendar year92567Tympanometry (impedance testing) Can also be performed by RN 1 per calendar year92570Acoustic Immitance Testing Can also be performed by RN4 per calendar year92583Select Picture Audiometry1 per calendar year92592Hearing Aid Check - Monaural4 per calendar year92593Hearing Aid Check-Binaural 4 per calendar year
Slide14Start and Stop Times
Enter the start and stop times for each service on the corresponding date at the bottom of the form.
These will be used to easily identify dates billable services were conducted for students with transportation services.
Slide15Start and Stop Times
Date
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
Start
Time
End Time Date161718192021222324252627
28
29
30
31
Start Time
End Time
Slide16Additional Documentation
Progress/therapy logs will also be required.
Original copies of progress/therapy logs must be on file in the special education central office.
There is not a required form for documentation of progress/therapy logs.
Slide17Signature and Credentials
Staff who provided the service will sign the form and list credentials.
For Therapists licensed by the WV Board of Examiners list credential as SLP.
Therapists licensed by WVDE and SLPAs authorized by WVDE must list their credential as SSLPA (School Speech Language Pathologist Assist)
Slide18SSLPA
An SSLPA can provide therapy but not evaluations for Medicaid billing purposes.
For an SSLPA to bill they must be indirectly supervised by an SLP.
Slide19Terry Riley – Coordinator
Office of Special Education
tjriley@k12.wv.us
304-957-9833
ext
53223
WVDE
Medicaid Website:
http://
wvde.state.wv.us/osp/medicaid.html