FEES coding

Can I code, and how would I bill, procedure 92612/92613 along with 31622 or 31623 and get reimbursed for all? Looking at it from a physicians point of view.

re: FEES coding

I do not see a CCI edit for billing 92612/92613 with 31622 or 31623. However, be mindful that 92612 is global and 92613 is only for the interpretation and report so it would have to be either or. You also need to keep in mind the medical necessity for billing both. I hope this helps.

Per AMA Assistant:

Endoscopic Laryngeal Sensation and Swallowing Function Evaluation Codes: 92612 Flexible fiberoptic endoscopic evaluation of swallowing; by cine or video recording
92613 physician interpretation and report only
92614 Flexible fiberoptic endoscopic evaluation, laryngeal sensory testing; by cine or video recording
92615 physician interpretation and report only
92616 Flexible fiberoptic endoscopic evaluation of swallowing and laryngeal sensory testing; by cine or video recording
92617 physician interpretation and report only

Codes 92612-92617 were added to report laryngeal sensation and swallowing function evaluation via endoscope. Code 92612 is intended to describe a flexible fiberoptic evaluation of swallowing within the pharynx and larynx typically performed by a physician or speech-language pathologist. Code 92613 (physician interpretation and report only) is intended to be reported by the physician in any of the following three instances. In the first example, the speech-language pathologist conducts the study, and the physician is present during the study. The physician interprets the findings and writes a separate report. In the second, the physician is not present while speech-language pathologist conducts the study and writes a report. The physician later reviews the videotape, interprets the findings, and writes a separate report.

In the third instance, the physician conducts the entire study, reviews the videotape, interprets the findings, and writes a report. In this latter situation, the physician performing the study would report 92612 and 92613. Code 92614 is intended to describe laryngeal sensory testing performed by a physician or speech-language pathologist to assess the larynx's ability to protect the lower respiratory system from aspiration of secretions and ingestants.

Code 92615 is intended to be reported by the physician in any of the following three instances. In the first, a speech-language pathologist conducts the study, and the physician is present during the study. The physician then interprets the findings and writes a separate report.

In the second, the physician is not present while the speech-language pathologist conducts the study. The physician later reviews the videotape, interprets the findings, and writes a separate report.

In the third instance, the physician conducts the entire study, reviews the videotape, interprets the findings, and writes a report. In this latter situation, the physician performing the study would report 92614 and 92615.

Codes 92616 and 92617 encompass both endoscopic evaluation of swallowing and laryngeal sensory testing on the same day. Code 92616 reports the endoscopic evaluation itself, whereas code 92617 describes the physician interpretation and report in a fashion similar to that described for 92613 and 92615.

92700 Unlisted otorhinolaryngological service or procedure

For the purpose of relocation, the unlisted otorhinolaryngological code 92599- Unlisted otorhinolaryngological service or procedure, was deleted and replaced by 92700 to allow expansion of this section.

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re: FEES coding

That does help, to get more specific...Generally the procedure is thru a trach tube. Usually is a Bronchoscopy. The speech pathologist is present and charges the 92612. My dr was wondering if it is legal for us to charge the Bronchoscopy fee for the procedure. I did read that we cannot both charge the 92612.

re: FEES coding

Without actually seeing how it's documented I can only comment on the information provided.

You are correct because it includes the interpretation and report.

If you are a POS 22 and the speech pathologist is employed by the facility AND 92612 is within her scope of practice AND she had her own NPI number then I see no reason why she cannot bill for 92612 BUT ON THE FACILITY SIDE ONLY. The provider would bill 31622 or 31623. Now if the provider separately documenting the interpretation and report then the provider would bill 92613

I would need a better understanding of your workflow in order to give a proper answer. This is the best I can do with what you have given me. I would also need to know the diagnoses that is being billed with both procedures.

re: FEES coding

The Procedures are done at either hosp in or out pat setting or nursing home. I am not sure if the speech path is on staff or not. We are independent physicians working at the POS'. We would perform the BR and she would Perform 92612. I do believe that the speech path uses a dysphagia DX. I would say we would use an aspiration DX or of course, 793.19. Hope that helps clarify.... So it would be okay for us to charge the Bronch and 92613, if we do a seperate interpretation and report? otherwise just the Br.

re: FEES coding

knowing who your speech pathologist and provider is employed by will make all the difference in the world when billing this. Does your practice employ the speech pathologist? Is your practice considered POS 11 or 22 (this can be found on the CMS 1500 form that has been generated or by asking your manager)?
I can't answer whether or not it would be correct to bill both unless I knew that information.

1. Who employs the speech pathologist?
2. Do they have their own NPI?
3. Is this study within their scope of practice?
4. What POS is you practice?

re: FEES coding

Have not abandoned this conversation, the Dr who asked, is on vacation and he would have the answers to #1-3....our POS is 22 or 21 on the form. We do not do bronch's in our office. Probably will not be able to get an answer from him on the speech path till monday...Thank you for your help up to this point!

re: FEES coding

I am in need of help with reporting 92612 and 92613 performed in an office setting by a speech pathologists that our ENT's are wanting to have performed on thier Medicare patients.What steps do I need to take to accomplish this? Would the SP need to be employed by us to bill for these services and could our ENT's bill for both services or just the intrep(92613)?.

Thanks.

re: FEES coding

http://www.asha.org/practice/reimbursement/medicare/physcn_bill_slp/