Eli's Rehab Report

Published on Fri Jul 01, 2016 PDF

Careful: Using both will get you a denial.

Most of the physical medicine CPT^® codes (the 97000s) are out of the speech-language pathologist’s playing field, right?

Exception: CMS says that SLPs may use 97532 (Development of cognitive skills to improve attention, memory, problem solving [includes compensatory training], direct [one-on-one] patient contact, each 15 minutes).

The question: If 97532 is fair game, then what makes this code different from the speech language treatment code of 92507 (Treatment of speech, language, voice, communication, and/or auditory processing disorder; individual)?

Key: Differentiate cognitive skills from communication skills.

Code 97532 is more appropriate when the SLP is addressing specific cognitive skills, says Nancy Swigert, MA, CCC/SLP, BRS-S, process excellence coordinator at Baptist Health in Lexington, KY. “For example, with a patient who has a right hemisphere injury, the SLP might work on visual scanning and sequencing to improve reading skills. This seems like a more discrete cognitive skill than communication, and, thus, I might be inclined to use 97532.”

Another example: Select 97532 when working with an individual post-concussion, who’s having difficulty with concentration, focus and memory, Swigert says.

“I select 92507 when the focus of treatment is on improved communication skills (receptive, expressive and even reading and writing) rather than on a discrete cognitive skill,” Swigert says. “Of course, some sessions are addressing both discrete skills and applying those skills for improved communication. In those cases, the SLP should select the code that describes the main focus of the treatment.”

Important: Don’t report both codes for one session. “Using a 92000 code in combination with a 97000 code may constitute unbundling of codes, and is not allowed,” according to the American Speech-Language Hearing Association (ASHA) website. “Unbundling is when you code one component of a treatment separately when that component is already captured under a more comprehensive code that you are also using.”