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.