1.0 CPT
PROCEDURE CODES
92605, 92607, 92608, 97755,
97608
3.0 POLICY
3.1 ACDs (also
referred to as Speech Generating Devices (SGDs) and medically necessary
services and supplies that provide an individual who has a severe
speech impairment with the ability to meet functional speaking needs
are covered. ACDs/SGDs are characterized by:
3.1.1 Being a dedicated speech device,
used solely by the individual who has severe speech impairment;
3.1.2 May have
digitized speech output, using pre-recorded messages, less than
or equal to eight minutes recording time;
3.1.3 May have digitized speech
output, using pre-recorded messages, greater than eight minutes
recording time;
3.1.4 May have synthesized speech
output, which requires message formulation by spelling and device
access by physical contact with the device-direct selection techniques;
3.1.5 May have
synthesized speech output, which permits multiple methods of message formulation
and multiple methods of device access; or
3.1.6 May be software that allows
a laptop computer, desktop computer or personal digital assistant
(PDA) to function as a speech generating device.
4.0 EXCLUSIONS
Examples of devices that do not meet the above
definition and are excluded from coverage as ACDs/SGDs include,
but are not limited to:
4.1 Devices that are not dedicated
speech devices, but are devices that are capable of running software
for purposes other than for speech generation, e.g., devices that
can also run a word processing package, an accounting program, or
perform other non-medical functions.
4.2 Laptop computers, desktop
computers, or Personal Digital Assistants (PDAs), which may be programmed
to perform the same function as a speech generating device, are
non-covered since they are not primarily medical in nature and do
not meet the definition of prosthetic, prosthetic device, prosthetic
supply, or Durable Equipment (DE).
4.3 Communication
aids that do not generate speech are not covered. Communication
aids that are not ACDs/SGDs are not considered prosthetics for speech.
Examples of noncovered communication aids include the following:
picture books; flashcards; Braille typewriters; Teletypewriter (TTY)
devices; devices that allow the patient to communicate messages
to others with writing (e.g., a display screen or printout) rather
than with synthesized speech; and devices that allow the user to
communicate with a computer rather than with another person. Although
these devices may be useful, they do not meet the definition of
an ACD/SGD, prosthetic, or DE.
4.4 Altered
auditory feedback devices are communication aids that are excluded
because they are not augmentative communication devices/voice prostheses.