Eli's Rehab Report

Question: Many times our speech-language pathologist evaluates patients for both communication and swallowing disorders in the same session. Should the SLP write that up as two different evaluations, and can I bill for two separate evaluations? 


California Subscriber


Answer: Medicare does reimburse for both evaluations provided on the same date of service -- but other payers may or may not. As far as the National Correct Coding Initiative (NCCI) edits, you're in the clear and will not need any modifiers because CMS does not list any swallowing evaluation codes (92610-92617) as edits with the communication evaluation code, 92506 (Evaluation of speech, language, voice, communication, and/or auditory processing).

The correct billing would be one unit of 92506 and one unit of 92610 (Evaluation of oral and pharyngeal swallowing function). Just remember, you'll need documentation to support the medical necessity of both evaluations and to justify billing 92506 and 92610 on the same day. You can incorporate these evaluations into a single plan of care -- which the physician or nonphysician practitioner must sign to certify the need for skilled SLP services under Medicare Part B. 
 
Answers to Reader Questions were provided by Rick Gawenda, PT, director of physical medicine and rehabilitation at Detroit Receiving Hospital.