Deaf pt

is there a code or modifier for deaf/mute translation since it doubles the time?

deaf patient

Can you charge a prolonged visit...ABSOLUTELY NOT! Deaf patients are covered under the ADA...to charge extra for communication is in complete violation of the american disablilties act... 13 hospitals in my state were brought up on a class action case...the deaf community won the case and the hospitals are under a detailed program to care for the deaf.

I don't get it

Why can't a doctor use the prolonged service code if the service is prolonged? If you document the time and meet the standards then you can bill for it. But if the reply was saying that just because you had to pay for a sign language interpreter you are entitled to use these codes, then I agree- No.

Ada

Americans with Disabilities Act (42 USC 12131-12134)
The ADA prohibits public accommodations from discriminating against people with disabilities. This entails furnishing auxiliary aids and services when necessary to ensure effective communication with individuals with hearing impairments, including in certain situations, providing an interpreter who is able to interpret sign language effectively, accurately, and impartially.

The ADA provides an exception for services that would impose an undue burden or would fundamentally alter your offered services. The fact that an interpreter’s charge exceeds the fee for the visit is not alone considered an undue burden.

Private individuals may bring lawsuits in which they can obtain court orders to stop discrimination. Individuals may also file complaints with the attorney general, who is authorized to bring lawsuits in cases of general public importance or where a pattern or practice of discrimination is alleged. In these cases, the attorney general may seek monetary damages and civil penalties. Civil penalties may not exceed $55,000 for a first violation or $110,000 for any subsequent violation.
The only way to account for this extra time is to submit one of the prolonged services codes (99354-99355), which requires 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. Note that Medicare and most other payers will not pay for the services of the translator even if they may be willing to pay for the extra visit time associated with using a translator if criteria is met. Some Medicaid carriers will allow a translator charge.

deaf patients

It is discrimination to charge a deaf patient for something that is offered for free to a hearing patient...communication. The American Disability Act covers deaf patients (or any handicap requiring extra equipment, ramps etc) for proper medical care, to do so is to discriminate, everyone is entitled to the same treatment, if the patient leaves the office not understanding instructions, test results etc really opens the provider up in the liability department also.
You can document the extra time required to speak with a deaf patient and charge the 22 modifier, however, if it isn't in your contract with the carrier, don't charge the patient the extra...to do so would be discrimination. There are countless encounters where providers have crossed the line, one I remember locally was an office refusing to take a TTY call, the office staff member told the interpreter on the phone that she didn't have time to take these kinds of calls. Needless to say, the provider was held liable, it was all on tape also through the relay service.

Wrong!

We do not give away communication for free! That is all I get paid for- I am a cognitist. I think and I advise. The modifier 22 is for procedures that are extended like a simpl ehernia repair that ends up not so simple. Time based coding is used all the time- a patient with new cancer, an newly diagnosed HIV patient, a diabetic starting insulin, etc. I never use a 22 and all I am doing is communicating!

I sympathize

I can sympathize with you signaturedoc. We had a deaf patient one time and we had to pay for the translator as well. I understand what the ADA is trying to do; however, it seems we are being punished monetarily for this. There should be a better way.