Neurology & Pain Management Coding Alert

Question: Which code should I use for using an interpreter with a Medicare patient?

Texas Subscriber

Answer: Medicare -- and many other payers -- don't separately reimburse interpretive services.

Physicians must 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.

Impact: Medicare and many private payers typically consider interpretive services -incidental- to the rendered service. The HCPCS Level II code set includes T1013 (Sign language or oral interpretive services, per 15 minutes) that can be used to report these services. State Medicaid services typically use T codes, which are not accepted by Medicare. Additionally, according to the 2009 Medicare Physician Fee Schedule, code T1013 is assigned the code status -I- (Not valid for Medicare purposes). Most payers designate T1013 for use only by contracted non-medical vendors.

What you can do: Verify in writing how you should bill for an interpreter's services with each of your individual payers before coding. Some state workers- compensation rules have created special non-HIPAA compliant codes that would be reported for interpreter/translator services for a patient covered under that specific state workers- compensation jurisdiction. You may need to contact a payer representative or check your individual policy to find this information.

Also, some payers may consider coverage for the extra time associated with treating a patient who requires interpreter services. Check with your payer to see if this might be a coding option.