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  1. Default Translator
    Exam Training Packages
    Is there a CPT code that specifys that the doctor needed a translator for an office visit? Or would the level of the E&M just go up a notch? If anyone can help me with this issue, thank you in advance.

  2. #2
    No, there is no additional code.

    You aren't automatically going to get a level up either. The only way that I am aware of that documenting a translator was needed by the patient could help your level is under social history for the patient.

    Most likely that won't make much of a difference, but it could if the provider didn't document any other elements of Past Family or Social history.

    Sorry to be the bearer of bad news but this is just part of the business. Some patients are more difficult and they just aren't going to get credit for it. On the flip side some are a lot easier and they are still getting the same credit. Supposedly it all evens out in the end.

    Laura, CPC, CEMC

  3. #3
    Everett, WA
    Laura, just curious...depending on the other elements of exam, would there not even be the remotest of possbility that the idea of an extended service (9935X) may be justified if the time element qualifies? Also, in this particular case, wouldn't we need to have more information in the chart note to determine if this could be upcoded (although the use of the interpreter wouldn't qualify it for consulation and coodination of care, would it?) based on E/M time coding? I'm interested in more research along these lines, too! Love this stuff!
    ---Suzanne, CPC-A

  4. #4
    Time based coding still has to meet medical necessity requirements.

    The best way to think of it is if this same service was provided to a patient without a translator, would it have taken as long?

    A good example is children. Some will sit on the table and let the providers examine them, takes a few minutes. Others, the providers have to chase them around the room, under the table, down the hall, etc.. same exam is done but it took 30 minutes.

    I have no doubt it took longer to treat a patient with a translator but if it is because everything had to be done in 2 different languages that doesn't support medical necessity.

    To completely level the service, you are correct more info is needed. Getting social history can change the level of history so it could impact the level of the visit.

    Having a translator would not affect the code set used.

    Hope this is helpful,

    Laura, CPC, CEMC

  5. Default
    Thank you Laura! It does help.

  6. Default Translator
    Under the Federal Americans with Disabilities Act, doctors that receive Federal funding must provide an interpreter at their own expense.

    A NJ doctor was recently sued and a judgement of $400,000 was awarded to a deaf patient because the provider didn't provide an interpreter.

    Individuals who do not speak English as their primary language and who have a limited ability to read, speak, write, or understand English can be limited English proficient, or "LEP."

    You can't discriminate against LEP patients by making them pay more than anyone else, as Laura explained above.

    And based on the jury award above, they took into consideration that this provider got paid well overall, not just the $49 for this one visit. Half of the award was punitive.

    You can learn more at
    Cyndee Weston, CPC, CMC, CMRS
    American Medical Billing Association
    AMBACode Coding Software
    2015 AMBA National Medical Billing Conference

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