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.