Otolaryngology Coding Alert

Question: What diagnosis code should I use with T1013 for using an interpreter?

Ohio Subscriber

Answer: HCPCS Medicaid code T1013 (Sign language or oral interpretive services, per 15 minutes) represents interpretive services for sign language or foreign language. Only one of these uses, however, has a clear diagnosis link. When using T1013 for a sign-language interpreter, you should use the hearing loss diagnosis (389.0x-389.9). But when you report T1013 for a foreign-language interpreter, no corresponding diagnosis exists.

Medicare and most 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 is not valid for Medicare, according to the 2008 Medicare Physician Fee Schedule, which assigns the code status I (Not valid for Medicare purposes).

Exception: Medicaid may reimburse for interpreter services. For instance, Vermont Medicaid reimburses T1013 at $15 per unit for 15-minute increments for in-person interpretation.-

Alternative: Medicare and other payers may pay for extra time associated with using a translator. For instance, 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.