Coding > Coding
speech therapy - communication device
Anne:
I just started billing for a Speech Therapist. (Other clients I have are PT and OT). The ST asked me to prepare a claim for one of her patients and file her primary ins. for a "communication device". She said they'll deny, but then we can file Medicaid and they will pay. I asked her the name of the communication device and she hasn't answered me yet. I've been reading about communication devices but don't see anything about billing for. I'm not familiar w/ DME codes, I'm assuming I'll need to use DME code for that claim. I don't want to say that I haven't done it before. But the truth is, I'm not so sure what I need to do for this claim. Do communication devices have codes? Do I use that in place of CPT code? dumb question, I know.
Steve Verno CMBS, CEMCS:
YOU must wait to hear from your ST regarding the specific communication device as there are many to choose from. Each one has its own HCPCS code. BEFORE YOU DO ANYTHING. you should check both the personal health insurance and MEDICAID to see if the device is a covered service and payable. YOU should also find out of your ST is enrolled with your Medicaid. If not, then all your work may be for nothing.
Some info is here:
http://websrvr.dmas.virginia.gov/manuals/DME/app_b_Commun_Devices.pdf
As it is said in X-files: TRUST NO ONE!
PMRNC:
Also.. I have to ask...who is the primary carrier? If they have primary insurance.. why the Medicaid? ??? ??? ???
Anne:
patient has United Healthcare as primary ins. and Medicaid secondary. and yes, provider is a Medicaid provider. I was definitely going to wait until she told me what specific device she was talking about and will check w/ patient primary ins. and we will have to get auth from Medicaid. will tell you more when I know. thanks for your quick reponse.
Anne:
ST says commucication device is Toby with eye gaze (cost is $13,000) Do you know about that?
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