AURAL PERCEPTION TRAINING HOW TO
AURAL PERCEPTION TRAINING CODE

AURAL PERCEPTION TRAINING CODE

For example, a payer most likely will deny a reimbursement claim for 92507 filed by an audiologist in the event that a speech-language pathologist submitted the same code on the same day for the same patient.

While the descriptors for these three codes appear straightforward, the reimbursement for each is not. The AMA's CPT manual, in the Special Otolaryngologic Services section, assigns three codes for aural rehabilitation:ĩ2507 Treatment of speech, language, voice, communication, and/or auditory processing disorder (includes aural rehabilitation) individualĩ2510 Aural rehabilitation following cochlear implant (includes evaluation of aural rehabilitation status and hearing, therapeutic services) with or without speech processor programming

There are very few rehabilitation or treatment codes for audiology services, while there are a myriad of diagnostic audiology codes. Depending on its coverage criteria and reimbursement policies, the payer then determines if the service is covered and if the practitioner is permitted by the plan to be reimbursed for the service. Procedural Coding.All health plans, whether private or governmental, require health care providers to use the American Medical Association (AMA) Current Procedural Terminology (CPT) when submitting claims for reimbursement. Therefore, we recommend that the audiologist or the patient's family review the patient's health plan and request clarification in writing of the coverage for audiology and rehabilitation services, before services are rendered. Thus, payers tend to perceive audiology as a diagnostic service only. Since its inception, the Medicare program has covered audiology as a diagnostic service. Payers receive considerably more claims for diagnostic audiology services than for rehabilitative audiology services. One reason for the complexity associated with reimbursement for aural rehabilitation is the mindset of payers.

AURAL PERCEPTION TRAINING HOW TO

That common language makes it easier to explain how to fit these three audiology practice areas into three different payment puzzles and offers some instruction about procedural and diagnostic coding. Medicare, Medicaid, and private health plans do have something in common-they use the same language (i.e., the same codes). More information about managed care can be found at. Managed care is broken down into health maintenance organizations (HMOs) and preferred provider organizations (PPOs)- with point of service (POS) options for both. Private health plans are typically offered by commercial insurance companies (e.g., Aetna and Prudential) and by non-profit health service corporations (e.g., Blue Cross and Blue Shield) and can be classified as either fee-for-service or managed care. The result in that coverage of audiology services varies significantly from state to state. Medicare is administered at the federal level by the Centers for Medicare and Medicaid Services (CMS), whereas Medicaid is administered jointly by the federal and state governments. Medicare, Medicaid, and private health plans-have different coverage criteria and reimbursement policies. One reason for the complexity is that the plethora of third party payers. This article focuses on billing and obtaining reimbursement for audiology services. Piecing together auditory processing evaluation and treatment, aural rehabilitation, and diagnostic programming of cochlear implant speech processors into different payment puzzles, such as Medicare, Medicaid, and private health plans can be a formidable task. What do aural rehabilitation, auditory processing and cochlear implants have in common? Anticipated coding and reimbursement changes will link the three together in significant ways.

Aural perception training