Eli's Rehab Report

Question: Sometimes our speech-language pathologist performs a swallow evaluation and video fluoroscopic swallow study (VFSS) on the same day. Can we bill for a swallow evaluation (92610) and radiopaque swallow study (92611) on the same day for the same patient?

Michigan Subscriber


Answer: Under Medicare Part B, the answer is yes. CMS, however, considers 92610 a component of the more comprehensive code, 92611, so you would need to append modifier 59 (Distinct procedural service) to 92610 on the claim form to have both reimbursed when provided on the same day. Also, your documentation would have to support the medical necessity of both services and that your SLP provided them at separate and distinct times.

See the link to the CMS National Correct Coding Initiative (NCCI) edits. Click on the appropriate link on the left hand side: www.cms.hhs.gov/NationalCorrectCodInitEd/.