SpeechPathology.com Phone: 800-242-5183

The Stepping Stones Group - Opportunities - November 2023

Professional Coding: Parts 1, 2 and 3

Professional Coding: Parts 1, 2 and 3
Robert C. Fifer, CCC-SLP
November 15, 2002

This article was originally published on our sister-website, "Audiology Online" (www.audiologyonline.com) and is republished here with permission. The editors of both websites believe this article has application for Speech Language Pathologists and is offered here for educational and academic purposes.

Editor's Note - Professional Coding: Parts 1, 2 and 3 were originally written and published as separate, concise articles. For CEU purposes, we have combined the original three articles, learning outcomes and examinations, into one larger, comprehensive document. Thanks, ---Editor

Professional Coding: Part One - Clinical Coding: CPT

In response to requests for information on procedural and diagnostic coding, I am writing the first of a multi-part series.

This first section will address CPT (Current Procedural Terminology) coding. Part Two will focus on ICD-9 diagnosis coding. Part Three will deal with V-codes, HCPCS, and the new CPT-5 and ICD-10 codes.

CPT codes are copyrighted and owned by the American Medical Association. These codes were established in the mid-1960s. The first CPT manual was published in 1983. The codes were written by physicians for physicians with no consideration of non-physician health care professionals. They were established as a first step toward standardizing health care terminology and to provide a means of objectively tracking services rendered.

As those of us who were in practice in 1983 will recall, if someone had asked you what your facility called a basic evaluation, the responses would be ''Comprehensive diagnostic evaluation'', ''Basic audiological evaluation'', ''Audiological assessment'', ''Basic evaluation'', ''Comprehensive evaluation'', and so forth. The point is, there were as many descriptors as there were clinics. Insurance companies had no standardized gauge by which to judge the value of our services. As a result, the AMA established a formal editorial panel to examine all medical procedures (of which speech, language, and hearing services were included). The AMA solicited input from various specialty disciplines. The section of the manual that covers what we do collectively is known as ''Special Otolaryngology Procedures''.

During the decade of the 1980s, the cost of health care skyrocketed. There were various reasons for this, perhaps the most famous of these was ''physician greed''. Without a doubt, that was a contributing factor, but I submit it was a relatively small part of the entire picture. Another part of the picture was ''Managed Health Care,'' which too, established a foothold in the 1980s. The first appearance of managed health care was in the form of HMOs and then various forms evolved. Several of the first HMOs were established by physician groups. The first HMOs were ''prepaid'' plans through which health care could be provided in a more cost effective manner. These prepaid plans quickly evolved into managed care plans as indemnity insurance companies became part of the picture. Also of note, through the 1970s and into the 1980s, insurance companies started to sell individual policies to single persons or to families. Employer supplied health insurance existed but was not necessarily the predominant factor in non-union situations.

Robert C. Fifer, CCC-SLP

Director of Audiology and SLP, University of Miami School of Medicine, Miami, FL

Related Courses

Is Private Practice Right for Me: Things to Consider Before Embarking on Your Journey
Presented by Sonia Sethi-Kohli, MS, CCC-SLP, Adrienne Wallace, MBA, MS, CCC-SLP
Course: #10540Level: Introductory1 Hour
This is Part 1 in a three-part series on private practice. This course discusses important considerations and provides tools and resources to help SLPs determine if private practice is right for them. Private practice options and methods for setting SMART (Specific, Measurable, Achievable, Relevant, and Time-Bound) goals to kickstart business ideas are also described.

Private Practice: Building Blocks for Starting or Growing a Successful Business
Presented by Sonia Sethi-Kohli, MS, CCC-SLP, Adrienne Wallace, MBA, MS, CCC-SLP
Course: #10646Level: Intermediate1.5 Hours
This is Part 2 in a three-part series on private practice. The critical elements of a foundational framework for establishing and growing a successful speech-language pathology private practice, along with examples of how SLPs can apply these to reach their own business goals, are presented in this course. Discussion also includes various service delivery models and methods for identifying potential target customers.

Developing Your Business Accent: Tips & Tools for Offering Accent Modification Services
Presented by Sonia Sethi-Kohli, MS, CCC-SLP
Course: #9145Level: Introductory1 Hour
Interested in offering accent modification, but don’t know where to start? This course will provide the basic building blocks of what you will need to establish/grow an accent modification business, some potential challenges to be aware of, and resources/tools to help you get started.

Expand Your Private Practice: Marketing, Branding, and Networking Strategies
Presented by Sonia Sethi-Kohli, MS, CCC-SLP, Adrienne Wallace, MBA, MS, CCC-SLP
Course: #10711Level: Intermediate1 Hour
This is Part 3 in a three-part series on private practice. Effective marketing of private practices is discussed in this course. Identifying a niche and a marketing message for the target audience, developing a brand, and expanding networks to obtain reliable referral sources and create opportunities for business growth are described.

Master Marketing for Your Private Practice: Advanced Strategies and Techniques
Presented by Sonia Sethi-Kohli, MS, CCC-SLP, Adrienne Wallace, MBA, MS, CCC-SLP
Live WebinarThu, Aug 1, 2024 at 12:00 pm EDT
Course: #10971Level: Intermediate1.5 Hours
An in-depth exploration of marketing, networking, and branding strategies and tools for private practices is described in this course. Strategies and practical guidance are provided for establishing marketing goals and tactics, enhancing social media presence, creating impactful marketing materials, and leveraging networks to drive business growth.

Our site uses cookies to improve your experience. By using our site, you agree to our Privacy Policy.