[DYSPHAGIA] DPNS this weekend

[cslewis@isugw.indstate.edu (Jeffrey Lewis)]

Dear Brenda:

This is exactly the kind of stuff that I was referring to in an earlier post.  There is NOTHING to substantiate the position of your intermediary per HCFA.  And yet, on a conceptual level, I don't have a real question that the issue is an debatable one from both points of view.  After all, is not oral muscular strengthening part-and-parcel with dysphagia therapy?  However, couldn't one say that oral muscular exercise is similarly a part of dysarthria treatment?  Yet on that one, intermediaries may not challenge the separation of the therapies.  The real key is to have good documentation that addresses the need for the muscular strengthening exercises in parallel with other dysphagia treatment.  For example, sessions dealing with muscular strength might be done on "one track" of care while compensation procedure education is done on another.  I believe that that might be a defendable position and prevail at hearing if it came to that.

The point is: We need to be careful what our intermediaries think.  Moreover, we need to be proactive and define what we're doing in ways that are professionally responsible and honest.  We can then perhaps educate the intermediary and refine their thinking.

Sincerely,
Jeff Lewis

<<< <Bklogsdon2@aol.com> 10/ 2  9:37p >>>
Hello,
In the Midwest (IN, KY, OH) our intermediary, Adminastar, recently clarified 
that SLP's are NOT to use the therapeutic exercise code for that portion of 
dysphagia therapy.  They state that "exercises" are an intrinsic part of 
dysphagia therapy and expected to be included.  This mention was in the 
August newsletter from Adminastar.  I personally would take that to mean that 
everything that is part of dysphagia therapy is to be billed under 92526.  I 
don't know of anyone who has used any other codes.

Brenda Logsdon, CCC/SLP
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