Eli's Rehab Report

Published on Fri Mar 12, 2010 PDF

Question: I am a director of rehab in a hospital setting, and I oversee a busy endoscopy clinic for our speech-language pathologists performing vocal and swallowing studies. A peer recently brought to my attention that the American Medical Association has deemed that 31579 (Laryngoscopy, flexible or rigid fiberoptic, with stroboscopy) "must be billed by a physician or physiciandirected clinic." Can you confirm that a hospital setting is "physician-directed"? Also, does a physician need to perform the procedure or be in the room?

--Michigan subscriber

Answer: If you're in a hospital setting, billing 31579 shouldn't be a problem because you are in a physiciandirected clinic (granted your clinic is following proper physician supervision guidelines). If you were in a private practice or some other outpatient setting and tried to bill for the same procedure, you would definitely see denials.

Check your local coverage determination, as well, for additional requirements. For example, the National Government Services Speech Therapy LCD reiterates that an SLP may perform the 31579 procedure to assess voice production and vocal function under direct physician supervision. The LCD also says SLPs doing this procedure "should have evidence that they meet the ASHA(American Speech-Language Hearing Association) training requirements as outlined in the ASHA's Training Guidelines for Laryngeal Videoscopy/Stroboscopy."