Just what we needed! Four more codes to keep track of! Actually if you are using JOTx, we keep track of them for you. Starting in January 2014, the following codes will replace 92506 speech language voice evaluation for the US therapists:

· 92521 Evaluation of speech fluency (e.g., stuttering, cluttering)
· 92522 Evaluation of speech sound production (e.g., articulation, phonological process, apraxia, dysarthria);
· 92523 Evaluation of speech sound production (e.g., articulation, phonological process, apraxia, dysarthria); with evaluation of language comprehension and expression (e.g., receptive and expressive language)
· 92524 Behavioral and qualitative analysis of voice and resonance

Interestingly there isn’t a code for just language evaluation. The assumption is that most of the time a language evaluation is performed in conjunction with evaluation of speech. If you perform a language evaluation without assessing speech sound production, you should add the 52 modifier to code 92523 when submitting the billing. That means that you will be paid less for that service. If you don’t like the idea of being paid less, then plan ahead. Include assessment of speech in your evaluation documentation.

If you bill Medicare, these new codes are also subject to the therapy cap and MPPR.

Another consideration with these new codes is that when you get a doctor order for therapy, the type of evaluation that you are performing should be specified. Some insurance companies might go for the global order for speech therapy to evaluate and treat as needed. A phone call to clarify the preferences of the insurance providers you work with is the best way to stay compliant with policies. If you don’t feel you have time for that, the next safest thing to do is check with the Medicare guidelines. They tend to be the most stringent and other insurance companies tend to follow the trends that they set.

It was such a pleasure to attend the ASHA convention in Chicago this year! Hearing Ben and Jerry speak at the opening session was a treat! What personalities! I like people with high entertainment value. They obviously know how to have a good time yet still take care of business. I would have loved the opportunity to hang out with them for a while. Their opening comments underscored the necessity of teamwork. The science of ice cream making and of course selling it, service delivery.

Those two friends are obviously very different people. Complimentary of each other, and still I’m sure they had their disputes. Their words of wisdom for us, “Subjugate your ego.” You have to know your strengths and weaknesses. Assemble a team that rounds out your weakness.

As a small business owner, I appreciate how challenging it can be to do those things. You want a good reputation for your business. You may even be aware of your strengths and weaknesses. Finding people that you trust to either work for you or collaborate with can take time. I often turn to my ASHA colleagues for wisdom when making these decisions.

Here are some great ways to network:
-have a network of local therapists and meet regularly.
-stay connected through professional organizations like the American Academy of Private Practice in Speech Language Pathology and Audiology
-love the ASHA special interest list serves! They connect a network of brilliant and experienced SLPs who are happy to share their knowledge.
-Give back to your community. Local volunteer opportunities and charitable donations are an excellent way to connect with other professionals in the area.

We are so excited to be at ASHA this year! We flew in on Tuesday, so we could hang
out in Chicago a little before feeling the press of the crowds at the convention
hall. And I’ve been reading articles about the ASHA convention. Sean Sweeny wrote
about his experience as a presenter in Easy Speak magazine. He is quite funny! When
I hear a presenter speak, I’m usually just caught up in all the good information
that they share; I never think that they *might* feel tense before walking up to the
podium. I suppose being in the spot light makes everyone tense the first time or
two… Can’t wait to actually hear what some of our presenters have to share and
see what’s new in the exhibit hall! I hope to have better insight into science and
service delivery working together. What a great theme!

My interpretation of it of course comes down to how we use technology tools to
enhance our therapy interactions. As it stands, I am a data driven therapist. I
collaborate with another speech therapist to offer social skills/ articulation
groups once a week. We plan out lessons together and then we each do our favorite
things during the session. Play with kids, laugh, and teach. We read the stories
and collect the data. Tap tap tap… 🙂 Then we use that data to direct the focus
of our next session, and we also like to think that we are always using evidence
based practices.

The reality about evidence based practice is that there is a small pool of knowledge
for what we KNOW works. Many of our interventions fall into the area of “don’t know
for sure but it doesn’t hurt.” So I like to rely on my treatment data to drive
intervention decisions.

Tracking data for some things seems black and white- 69% correct for final /s/ in
sentences. But it’s actually more complex than just that. What compensations did
the individual use? How much support in the way of verbal, visual, and tactile cues
were provided by the therapist? What was the environment like? Were the activities
high structured or low structured? All of these variables influence performance.
It’s true for articulation, it’s true for eye contact, and it’s true for any
exercise that you ask your clients to participate in.

If you are not tracking the complexity of the scenario, then your data could falsely
give the sense that progress is not being made. So I keep track of context. And
that is how I keep science in my sessions, driving the decisions that I make for
service delivery.

Really looking forward to hear how others interpret this theme. And hoping to walk
away with more insight for my clinical practice…. And maybe a few new friends!

Best,
Jessica

We (the JOTx team) attended the Washington Speech Language Hearing Association Convention (WSLHA) in Everett, Wa. It was so GREAT! The raffle prizes were motivating! The food was tasty (and even contained gluten/dairy free options for people with those needs)! We reconnected with old friends and former professors. And best of all I attended some excellent sessions! They were the kind of sessions that I love. Ones where you not only get useful information about the research behind a therapy technique but you also get the opportunity to see what the application of that research looks like in a therapy session.

One session that really stood out was on was Phonomotor processing. The researchers at the UW Aphasia lab are using Lindamood-Bell theory to retrain phonological awareness and cognitive processes in individuals who have had a stroke! And it’s working!!! This technique is improving word retrieval, processing speed, and reading- all at once! Cool stuff. And yes, JOTx contains all those phonological awareness exercises that you would want to use, so that your data tracking and note writing is less cumbersome.

Conferences are so motivating. Those are the kind of CEUs that are so fun to collect!

It was also apparent once again how important it is to support our local and national organization. They really do a great job of advocating for our profession and our clients. There is a lot to be had through participation and we give power to our voice in government when we participate.