Radiology Coding Alert

Question: I have a hearing-impaired Medicare patient who insists that we provide him with a sign-language interpreter at each visit. Is there a code or modifier we can use to be reimbursed for the additional time and the interpreter?

Indiana Subscriber
 
Answer: You have limited options when it comes to both supplying the interpreter and getting reimbursed.

If the patient makes a request, the federal Americans with Disabilities Act (ADA) requires you to provide a sign-language interpreter for office visits if you can get effective communication only through an interpreter. If you do not consider the information to be particularly complex or important, the ADA allows you to use written communication.

If you do think an interpreter is the best option, the patient's family member or friend qualifies, if you believe he'll be effective, impartial, and acceptable to the patient. Let the patient know that the ADA allows you to choose among alternatives, especially if the request would fundamentally alter the nature of the services or it presents an undue burden to you. Courts don't believe that the cost of the interpreter exceeding the reimbursement is an undue burden. Remember, the purpose is for you to supply effective communication.

The ADA does not allow you to charge the patient either directly or indirectly for this service. The IRS may give you a tax credit to apply to your business expenditures made in compliance with the ADA.

If the situation arises again, but with a non-Medicare patient, you may be able to report HCPCS code T1013 (Sign language or oral interpretive services, per 15 minutes). The T codes were designed for Medicaid agencies, but some private payers do accept them. 


- The answers for You Be the Coder and Reader Questions were reviewed by Cindy C. Parman, CPC, CPC-H, RCC, co-owner of Coding Strategies Inc. in Powder Springs, Ga.; and Gary S. Dorfman, MD, FACR, FSIR.