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Pediatric Assessment Code

Dee Adams Nikjeh, Ph.D., CCC-SLP

September 8, 2014

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Question

If my speech and language testing for a 5-year-old child includes two 1-hour sessions on separate days plus a 45 minute additional session with the parents to explain results, how is this coded?

Answer

This is only coded once.  There is actually two hours of time built into the value of 92523 and that does include discussion with the parent or caregiver.  Whether you spend 10 minutes or 45 minutes with the parents, 45 minutes is not going to be recognized.  It is going to be looked at as very excessive.  It is difficult to get that post-treatment time built in.  However, we do have a number of minutes built in to that 92523.  I do not recommend that you bill this code more than once, that you do not string it out over several sessions.  I would try and get the evaluation done in one time.  If you need to do further tests and measures as an assessment to supplement, then I could look at that as a 92507, which is a treatment session.  

Dr. Nikjeh is co-chair of the Health Care Economics Committee of the American Speech Language and Hearing Association (ASHA). She has appeared before the U.S. Dept of Health and Human Services on behalf of ASHA to propose new diagnostic codes and modifications of existing codes for the benefit of speech-language pathologists.  Dr. Nikjeh is an ASHA advisor to the American Medical Association Health Care Practitioner Advisory Committee where she has presented speech-language pathology procedure codes for valuation of professional service.


dee adams nikjeh

Dee Adams Nikjeh, Ph.D., CCC-SLP

Dr. Nikjeh is co-chair of the Health Care Economics Committee of the American Speech Language and Hearing Association (ASHA). She has appeared before the U.S. Dept of Health and Human Services on behalf of ASHA to propose new diagnostic codes and modifications of existing codes for the benefit of speech-language pathologists.  Dr. Nikjeh is an ASHA advisor to the American Medical Association Health Care Practitioner Advisory Committee where she has presented speech-language pathology procedure codes for valuation of professional service. Her clinical experience spans thirty years.  She provides services for patients of West Coast Ear, Nose and Throat Association specializing in endoscopic procedures for evaluation and management of voice disorders.  Dr. Nikjeh is a consultant for the United States Dept. of Justice, Civil Division-Fraud Section and is an associate of Fearon & Levine, a national consulting firm that focuses on practice management and payment policy in outpatient rehabilitation settings. Dr. Nikjeh is an ASHA Fellow and has served on ASHA's Legislative Council and Executive Board of the Council of State Association Presidents. She is a past-president of the Florida Association of Speech Language Pathologists and Audiologists.


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