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New Medicare Billing Policy for Dysphagia Treatment and Cognitive Skills Treatment

5/25/2012

 
ASHA requested a clarification from the Centers for Medicare and Medicaid Services (CMS) regarding the billing policy for treatment of Dysphagia and treatment of Cognitive Skills provided to the same Medicare patient on the same day.

The CPT codes in question are below:
  • 97532: Development of cognitive skills to improve attention, memory, problem solving (includes compensatory training), direct (one-on-one) patient contact by the provider, each 15 minutes.
  • 92526: Treatment of swallowing dysfunction and/or oral function for feeding.
"CMS responded to the letter, stating "...if an SLP separately performs the services described by CPT code 97532 entirely unrelated to the services described by CPT code 92526, the services may be reported separately." For these cases, the modifier -59 would be added to CPT code 97532."


To see the full article as reported in the ASHA Leader, click on this link: http://www.asha.org/Publications/leader/2012/120515/Bottom-Line--Co-Billing-of-Cognitive,-Dysphagia-Codes.htm

Effects of Effortful Swallow on Esophageal Peristalsis

12/18/2011

 
Esophageal dysfunctions are typically re-referred to GI and mostly treated using medications with varying success.  The study concentrating on the utilization of the Effortful Swallow on Esophageal Dysfunctions manometrically examined the effects of an effortful pharyngeal swallow to assess the impact it may have on esophageal function.  The effortful swallow (swallow strong) yielded greater esophageal amplitudes and longer esophageal duration which decreased incomplete bolus clearance.  Wake Forest University, Winston-Salem NC (Butler, et al)  

Effects this study can have on how we conduct Treatment of Esophageal Dysfunction:  We know that the Effortful Swallow improves bolus clearance from the vallecullae and the hypopharynx via increasing effort on swallow.  Anatomically, when a patient uses the Effortful Swallow, they are using as much force as possible to increase hyolaryngeal excursion, and clearance of bolus through to the UES.  The effort used to increase the hyolaryngeal excursion also increases the opening of the UES and the opportunity for bolus to pass through to the UES.  We currently do not have many available options to treat esophageal dysphagia, so this research is exciting news!

Swallowing APP

12/18/2011

 
iSwallow App for Dysphagia patients.  Believe it or not.. it's here!  I haven't actually used it yet myself, but if the information on the APP is up to date, it can probably be very useful to the patient as a guide to help them practice their exercises in between sessions.  Thoughts?

Electrical Stimulation: Evidence FOR and Against?!

12/17/2011

 
Point/Counterpoint: Electrical Stimulation for Dysphagia: The Argument
Against Electrical Stimulation for Dysphagia
Ianessa A. Humbert
Perspectives on Swallowing and Swallowing Disorders (Dysphagia) 2011;20
102-108

http://div13perspectives.asha.org/cgi/content/abstract/20/4/102?etoc

The more and more I read about evidence against eStim makes me weary... HOWEVER, in the same journal, an article was posted "The Argument FOR Electrical Stimulation for Dysphagia"

Which definitely makes it fair.... but more difficult to decide it's efficacy
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    Amy Reinstein, M.S., CCC - SLP
    SIG 13 Affiliate

    Passion for all things Speech and learning to be a techie too!  Would love to hear feedback from viewers and if you have things you would like to see on the website, please contact me and I would be happy to oblige!


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  • Home
  • Speech Therapy Materials Store
    • Free SLP Downloads
  • Dysphagia
    • The Normal Swallowing Process
    • Brain & Cranial Nerves
    • Guidelines for Safe Swallowing
    • Imaging Examinations
    • Dysphagia Diagnosis
    • Hydration
    • Dysphagia Diets
    • Oral Care/Oral Hygiene
    • Predictors of Aspiration Pneumonia (AP)
    • Dysphagia Treatment Strategies >
      • Tube Feeding
  • Language
    • Developmental Milestones
    • Early Language Learning
    • Enhance Your Child's Communication
  • Aphasia
    • Symptoms of a Stroke
    • Language After Stroke
    • Aphasia Treatment
  • AAC
  • Autism
    • Therapy
    • Sensorimotor
    • Stimulation
  • Feeding
    • Oral Motor
    • GI Disorders in Pediatric Feeding
    • Drooling
  • Articulation vs Phonological
    • Speech Sound Development
    • Articulation Therapy Materials
  • Literacy
    • Reading
    • Processing Disorders
    • Literacy Treatment
    • Phonemic Awareness Treatment
  • Voice
    • Voice Tips
    • Voice Therapy
    • Voice Modifications
  • Motor Speech Disorders/Dysarthrias
    • Classifications of the Dysarthrias
  • Stuttering
    • Normal Fluency Development
    • Enhance Fluency at Home
    • Deal with Stuttering Effectively
  • Speech & Language Therapy Treatment Materials
    • Speech Therapy Material Links >
      • AAC
      • Speech Therapy APPS
  • Resources
  • Blog/News
  • Patient Advance Directives
  • The Speech & Swallow Clinic of South Florida
    • Speech and Language Services & Payment Options
    • Client History Forms
    • About Us >
      • Contact Us
      • Sponsorship & Collaboration
  • Contact Us
  • Speech Store