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Speech-Language Therapy Review Criteria Guidelines, 2009 Update

Published by: Apollo Managed Care Consultants

Published: Jan. 1, 2009 - 111 Pages


Table of Contents


Preface, Disclosure, Copyright Information

Table of Contents

Speech-Language Pathology Therapy

Speech Therapy Services Review Criteria Guidelines- skilled, unskilled; Coverage (update 08-04, 4-05, 6-05, 9-05, 4-06, 12-06, 7-07, 12-08)

Medicare benefits (update 5-08)

Medicaid benefits (New 11-06, update 3-08)

VA benefits (New 12-06)

Documentation guidelines for payment by Medicare (New 1-07)

Screening for speech-language delays in preschool-age children (New 11-06, update 3-07)

Speech-language initial visits for specific abnormalities (update 9-05)

Chronic acquired disorders affecting speech - also refer to ‘post-laryngectomy’, ‘Apraxia/post-stroke’ and other entities that follow

Parkinson’s disease (New 4-07)

Aphasia (New 7-06) - refer to post-laryngectomy guideline that follows

Post-stroke speech therapy (New 12-06, update 6-07)

Melodic intonation therapy for persistent aphasia (updated 06-01, 4-05, 6-06)

Notes

Amyotrophic lateral sclerosis (ALS) (New 7-06)

Dysphagia - evaluation of swallowing mechanisms (review 4-06, updates 6-07, 10-08)

VitalStim (New 2-07, update 9-07, 1-08)

Oral-Motor and other therapies for dysphagia (new 2-01, update 5-05, 6-06)

Pediatric Speech-Language Therapy (New 6-06, update 7-07) - also refer to stuttering and other entitites that may appropriately require treatment during childhood.

Language delays (update 11-07)

Dyslexia

Hyperlexia

Hearing impairments

Augmentative communication needs for children

Coverage

Developmental services referral form - example - link

Resource links for additional information

Cerebral Palsy

Cleft Lip/Palate (New 7-06)

Velopharyngeal dysfunction (VPD) (New 7-06)

Stuttering (New 1-05, update 8-05, 6-06, 7-07, 5-08)

Lidcombe program for stuttering (New 8-05)

Apraxia/dyspraxia of Speech (New 7-06, update 12-06)

Post-stroke interventions for apraxia of speech (New 12-06)

Audio-visual entrainment (New 7-07)

Autism, Asperger Syndrome and Other Pervasive Developmental Disorders (new 11-02, update 12-04, 5-05, 7-06, 2-07, 3-08, 12-08)

Post-laryngectomy speech-language therapy (New 3-07)

Sensory or auditory integration therapy - refer to the Autism guideline and reference list Tongue Thrust Disorders/Therapy (New 7-06, update 7-07)

Traumatic brain injury

Table of Contents continued on the following pages

Speech-Language Therapy - Review Criteria Guidelines

Guidelines for authorization review or clinical care are necessarily incomplete and do not represent a standard of

care. Standards of medical care are determined on the basis of all the facts and circumstances involved in an

individual case and are subject to change as scientific knowledge and technology advance. Any guideline must be

modified as clinically necessary by those responsible for a patient’s management.

Vocal Cord/Fold Disorders/Voice Therapy - Diagnosis & Management

Laryngoscopy, diagnostic (update 1-06)

Videostroboscopic laryngoscopy (New 6-05)

Vocal Cord Disorders/Voice Therapy (New 12-06, update 5-07)

Vocal Cord Injections/Injection Laryngoplasty and Related Procedures (New 6-05)

Discontinuation of Speech-Language Benefits (rev 11-00)

Notes - childhood disorders and review issues

CMS Edits for Speech-Language Pathology (added 11-00)

Quality/Outcome Assessment of Speech-Language Therapy Programs (New 12-05, update 7-06)

Communication or Speech Generating devices/Voice Prosthesis

Alternative or Augmentative Communication (AAC) Aides/Devices (Revised 7-06, 4-07)

Speech Generating Devices - overview (New 4-06, update 5-07)

Tango (New 7-06)

Tracheo-esophageal voice prostheses, Indwelling (New 08-01, update 5-05, 4-06)

References and resources - communication devices -refer to the Addendum

Audiology/Hearing-related tests & procedures

Audiological testing/Audiometry/Audiology services (New 3-01, updated 11-01, 12-04, 3-05, 7-06, 7-07, 3-08)

Auricular prosthesis (New 11-08)

Early Intervention Programs (New 8-06)

Auditory Brain Stem Implants; Auditory osseointegrated & auditory brain stem devices (New 10-05, update 12-05)

Aural rehabilitation therapy for hearing-impaired patients (new 08-01, update 12-04, 2-07)

Brain stem auditory evoked response (BER, BAER) (update 5-05)

Carbogen inhalation therapy for the treatment of sudden hearing loss (new 2-01, update 12-04)

Cochlear and brain stem implants (update 9-03, 4-05, 7-05, 11-05, 7-06)

Audiology web links/Notes (new 4-08)

Addendum

Coding: link (New 2-07)

Software for computerized speech (New 8-07)

Speech-Language Pathology Terms

Speech-Language Pathology Acronyms

Speech-Language Pathologists - work, credentials (New 4-06)

References & Resources for Speech-Language Therapy (updated 12-01, 4-05, 11-05, 7-06, 7-07, 12-08)

Speech-Language

Notes

Web resources

Georgia Dept. of Education Instructional & Professional Resources / Speech Therapy - annotated links (New 11-06)

English Pronouncing Dictionary link (New 6-08)

Apollo’s publication list, Order sheet

Abstract

What's covered, what's not. Comprehensive clearly written guidelines for adult & pediatric speech-language pathology therapy + related tests, DME and hearing-related therapy & procedures with authoritative references/resources including informative speech-language web links.

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