CPT Code 92610: A Complete Guide for Speech-Language Pathologists

Evaluation of oral and pharyngeal swallowing function is an crucial provider furnished by means of speech-language pathologists (SLPs) treating dysphagia, or swallowing issues. Proper coding for these offerings ensures accurate documentation and billing. This manual will provide an explanation for the whole lot SLPs want to know approximately CPT code 92610, which includes proper use, billing requirements, and repayment.

What is CPT Code 92610?

CPT code 92610 refers back to the Evaluation of oral and pharyngeal swallowing function. This code covers the assessment strategies worried in comparing the oral education, oral transit, pharyngeal transit, and universal safety and efficiency of swallowing.

The purpose of this evaluation is to determine the character and severity of the swallowing sickness. It establishes a baseline to measure progress and manual remedy planning.

Services Included in 92610

CPT code 92610 consists of the following evaluation additives:

• Clinical swallowing exam with a variety of food textures and liquid consistencies
• Assessment of oral facial musculature and oral motor function
• Patient history applicable to swallowing problems
• Behavioral observations of ingesting and swallowing
• Trials with meals and liquid boluses to check feature
• Consultation and patient education

This code covers the work of the assessment, such as the face-to-face time with the affected person and any pre and submit-visit work. 92610 can not be billed at the side of assessment codes for cognitive communique disorders or voice/speech issues.

How to Use CPT Code 92610

When billing CPT code 92610, SLPs need to follow these guidelines:

• Bill only as soon as per day – 92610 isn’t a time-based totally code, so that you can’t invoice it more than one times consistent with day irrespective of the period of the evaluation.
• Provide distinct documentation – Notes must genuinely outline the checking out and evaluation processes finished and support clinical necessity.
• Link diagnosis to swallowing problems – The swallowing difficulties being evaluated ought to relate to a longtime scientific diagnosis like stroke, most cancers remedy, neurological disease, and many others.
• Specify treatment – Documentation need to establish a baseline and imply how the results will manual dysphagia intervention.
• Use modifier -52 if billing a reduced or constrained evaluation.

Example Documentation with 92610

Patient is a 78-year-antique male publish cerebrovascular accident with suggested problem swallowing skinny drinks. Clinical swallow examination carried out with various bolus displays to evaluate all phases of swallowing. Patient demonstrated reduced lingual variety of movement, delayed pharyngeal reaction, and aspiration on skinny beverages. Education furnished on safe swallowing techniques. Results will manual dysphagia therapy 2x/week for 6 weeks.

Correct Coding Guidelines for 92610

To keep away from reimbursement issues, SLPs want to take care to code 92610 successfully:

• Don’t bill 92610 for swallowing assessments that do not have a related medical diagnosis.
• Don’t invoice 92610 for an evaluation performed best by means of instrumentation like fiberoptic endoscopic assessment of swallowing (FEES). Use codes 92611-92617 for instrumental tests.
• Don’t invoice 92610 if acting simplest swallowing treatment with out an evaluation. Use 92526 for dysphagia treatment classes as a substitute.
• Don’t bill 92610 on the identical day as other evaluation offerings like 92521-92524 for cognitive communique or 92507-92508 for speech/voice problems.

Can 92610 and 92526 Be Billed Together?

CPT codes 92610 and 92526 can’t each be billed at the same date of service.

• 92610 is for the preliminary dysphagia evaluation most effective.
• 92526 is for swallowing remedy periods.

If appearing an evaluation and remedy at the equal day, most effective invoice for the evaluation 92610. The first day of any billable treatment is considered included inside the evaluation carrier.

What is the Reimbursement Rate for 92610?

Reimbursement prices for CPT codes vary through location and payer. According to the Medicare Physician Fee Schedule, the countrywide common price quantity for 92610 in 2023 is $83.64.

Always check with neighborhood payers to decide the repayment fee in your geographic place. Rates will rely on factors like:

• Medicare vs non-public payers
• Facility vs nonfacility placing
• Billing modifiers affecting price
• Geographic practice value index