Medicaid Billing Module Speech Therapy Billing Form Changes

Medicaid Billing Module Speech Therapy Billing Form

Changes • Services must be documented on the current IEP for meetings held prior to August 1, 2015. • Services must be documented on Service Care Plan for IEP meetings held after August 1, 2015. • As of August 1, 2015 Speech specific ICD diagnosis codes are required. ICD-9 codes are in effect through September 30, 2015. ICD codes must relate to the specific type of therapy being provided. A global code such as Autism would not be sufficient. • As of October 1, 2015 Speech specific ICD-10 diagnosis codes are required.

ICD 10 Diagnosis Codes Typically Used for Speech Services This is not a complete list of ICD 10 codes. These are the most frequently codes used by speech therapists. If there additional codes you need to use, send this information to Terry Riley at the e-mail on the last page. • • F 80. 0 Phonological disorder (Articulation) F 80. 1 Expressive language disorder F 80. 2 Mixed receptive-expressive language disorder F 80. 4 Speech and language development delay due to hearing loss

ICD 10 Diagnosis Codes for Speech Services Continued • F 80. 81 Childhood onset fluency disorder • F 80. 89 Other developmental disorders of speech and language • F 80. 9 Developmental disorder of speech and language, unspecified

ICD 10 Diagnosis Codes for Speech Services Continued • Q 38. 3 Other congenital malformations of tongue (tongue thrust) • R 13. 0 Aphagia • R 13. 10 Dysphagia, unspecified • R 13. 11 Dysphagia, oral phase • R 13. 19 Other dysphagia

ICD 10 Diagnosis Codes for Speech Services Continued • • • R 47. 01 Aphasia R 47. 02 Dysphasia R 47. 1 Dysarthria and anarthria R 47. 8 Slurred Speech R 47. 82 Fluency Disorder in conditions classified elsewhere

ICD 10 Diagnosis Codes for Speech Services Continued • • • R 49. 0 Dysphonia (Hoarseness) R 49. 1 Aphonia (Loss of Voice) R 49. 21 Hypernasality R 49. 22 Hyponasality R 49. 8 Other voice and resonance disorders • R 62. 0 Delayed milestone in childhood

Physician Authorization • Physician Authorization is still required annually to bill for speech services. • Authorization can now be from a Physician's Assistant or an Advanced Practice Registered Nurse (APRN). • Authorization is good for one calendar year from the date signed. • ICD 10 codes assigned by therapist are placed on authorization form. Physician is confirming those diagnosis codes when signing.

Student Demographics • Complete this section taking note of the following issues • The diagnosis code is to be an ICD 10 code that matches the need for speech therapy and service(s) being provided. • For provider name print the name of the person providing the service.

Student Demographics Sample Medicaid Number Last Name First Name 000000 Doe Jane WVEIS Number Diagnosis Code Date of Birth 99999 F 802 01 -01 -1900 County School Provider Name 059 203

Procedure Codes • Complete date of service and number of units under the appropriate heading for each day of therapy/evaluation. • There are two columns for individual therapy and group therapy. • If the Service was provided through Telehealth add GT to the date’s service.

Procedures # 92507 Dates of Service/units # 92508 Date of Service/Units # 92508 Date of Service/units #92521 Date of Service #92522 Date of Service #92523 Date of Service 8 -17 -15 /2 8 -24 -15 /2 8 -31 -15 /2 8 -19 -15 / 2 #92570 Date of Service #92583 Date of Service #92592 Date of Service #92593 Date of Service #92524 Date of Service #92561 Date of Service #92567 Date of Service

Explanation of Procedures and Caps Code 92507 92508 92521 92522* 92523* 92524 92561 92567 92570 92583 92592 92593 Procedure Treatment of speech language, voice, communication, and/or auditory processing disorder (includes aural rehabilitation); Individual therapy session Treatment of speech language, voice, communication, and/or auditory processing disorder (includes aural rehabilitation); Group, two or more individuals Evaluation of speech fluency (e. g. , stuttering, cluttering) Evaluation of speech sound production (e. g. , articulation, phonological process, apraxia, dysarthria) Evaluation of speech production (e. g. , articulation, phonological process, apraxia, dysarthria); with evaluation of language comprehension and expression (e. g. , receptive and expressive language) Behavioral and qualitative analysis of voice and resonance Beskey Diagnostic Tympanometry (impedance testing) Can also be performed by RN Acoustic Immitance Testing Can also be performed by RN Select Picture Audiometry Hearing Aid Check - Monaural Hearing Aid Check-Binaural Service Unit 16 units per month at 15 minutes per unit 1 per calendar year 1 per calendar year 4 per calendar year

Start and Stop Times • Enter the start and stop times for each service on the corresponding date at the bottom of the form. • These will be used to easily identify dates billable services were conducted for students with transportation services.

Start and Stop Times Date Start Time End Time 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 Date Start Time End Time 16 18 19 20 21 22 23 24 25 26 27 28 29 30 31 17

Additional Documentation • Progress/therapy logs will also be required. • Original copies of progress/therapy logs must be on file in the special education central office. • There is not a required form for documentation of progress/therapy logs.

Signature and Credentials • Staff who provided the service will sign the form and list credentials. • For Therapists licensed by the WV Board of Examiners list credential as SLP. • Therapists licensed by WVDE and SLPAs authorized by WVDE must list their credential as SSLPA (School Speech Language Pathologist Assist)

SSLPA • An SSLPA can provide therapy but not evaluations for Medicaid billing purposes. • For an SSLPA to bill they must be indirectly supervised by an SLP.

Terry Riley – Coordinator Office of Special Education tjriley@k 12. wv. us 304 -957 -9833 ext 53223 WVDE Medicaid Website: http: //wvde. state. wv. us/osp/medicaid. html