Medicare Compliance & Reimbursement

Question: Which diagnosis code should I use with T1013 for using an interpreter? Answer: Medicare and most other payers do not separately reimburse interpretive services. Physicians are required to comply with the 1964 Civil Rights Act, as amended; Section 504 of the Rehabilitation Act of 1973; the Age Discrimination Act of 1975; the Omnibus Reconciliation Act of 1981; the Americans with Disabilities Act of 1990; and all other applicable federal and state laws that prohibit discrimination in the delivery of services on the basis of race, color, national origin, age, sex, handicap/disability, or religious beliefs. So Medicare and private payers usually consider interpretive services "incidental" to the rendered service, such as an office visit (99201-99215). Code T1013 (Sign language or oral interpreter services, per 15 minutes) is not valid for Medicare, according to the 2008 Medicare Physician Fee Schedule, which assigns the code status I (Not valid for Medicare purposes). Alternative: Medicare and other payers may pay for extra time associated with using a translator. For instance, the Vermont Medical Society suggests accounting for the extra time with prolonged services codes (99354-99355), which require that the face-to-face time spent with the patient extend at least 30 minutes beyond the typical time associated with the appropriate CPT services.