Understanding Voice Therapy
?Voice? is basically the sound that is produced by the voice box (larynx).? Think of it as the noisemaker upon which the sound produced is modified to ultimately produce speech. ?Voice? is created before speech.? Voice problems are limited to anatomical or functional abnormalities of the larynx resulting in a raspy, hoarse, or breathy sounding voice. Such problems may be the result of vocal cord nodules, vocal cord polyps, spasmodic dysphonia, paralyzed vocal cords, etc.? Speech on the other hand is basically the sound that is produced by a person.? Speech issues are commonly related to problems stemming from the lips, tongue, palate or throat.
What is Voice Therapy?
Voice therapy is an approach to treating voice disorders that involves vocal and physical exercises along with behavioral changes. According to Medscape, ?Voice therapy encompasses a myriad of techniques employed in the management schema for patients with voice disorders. These techniques may seek to eliminate potentially harmful vocal behaviors, alter the manner of voice production, and/or enhance vocal fold tissue healing following injury. Emerging data suggest that voice therapy is an effective and appropriate method of therapy either in itself or as a compliment to other treatment modalities (e.g., surgery, medications).? [1]
Who can provide Voice Therapy?
A voice therapist is a speech-language pathologist with extensive experience and interest in voice disorders.???
Is it a Covered Service?
Payers such as Aetna consider voice therapy medical necessary to restore the ability of the member to produce sounds from the larynx for conditions such as traumatic injury or surgery of the vocal cords, laryngeal cancer, vocal cord nodules, vocal cord paralysis, etc. ?Voice therapy is not considered medically necessary for essential voice tremor, improvement of voice quality, laryngitis, or for occupational/ recreational purposes (public speaking or singing), etc. [2].
How is Voice Therapy reported?
CPT? codes 92506, 92507 and 92508 are defined in the CPT? manual as ?treatment of speech, language, voice, communication and/or auditory processing disorder; individual? and are used to report voice therapy. Codes 92506, 92507 and 92508 are not considered time-based codes and should be reported only one time per session; in other words, the codes are reported without regard to the length of time spent with the patient performing the service.
Because the code descriptor does not indicate time as a component for determining the use of the codes, only one unit should be reported for code 92506, 92507 and 92508 per date of service.
Catching the Schemes
Treatment of speech, language, voice communication provided in an individual session is reported with CPT? code 92507.? Group (2 or more individuals) therapy is billed with code 92508.? A practitioner billing an excessive number of individual sessions per day (code 92507) could indicate he/she is actually providing group therapy.? Check the provider?s Website ? does the practice offer group sessions?
A common error in reporting voice/speech therapy is billing the services as though they are time-based codes similar to the physical therapy codes which are reported in 15-minute increments.? As stated above, the codes should be only reported as one unit per day.? Data mine for providers (both professional and facility) billing multiple units per day of code 92506, 92507 and 92508.
Also beware of providers disguising medically unnecessary voice therapy.?? With an aging population of baby boomers, practitioners are now offering anti-aging voice therapy.?? The American Academy of Otolaryngology lists a Fact Sheet on their Website: ??The Voice and Aging? which states; ?Consider a vocal fitness program (i.e. voice therapy), as healthy voice use is key to voice preservation. Under the guidance of a speech-language pathologist, a vocal fitness program can make a big difference.? ??This type of service would not be considered medically necessary. [3]
References:
[1] http://emedicine.medscape.com/article/866712-overview
[2] http://www.aetna.com/cpb/medical/data/600_699/0646.html
[3] http://www.entnet.org/HealthInformation/Voice-and-Aging.cfm
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