1.0 CPT 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 an SGD.
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 PDAs, which may be programmed to perform the same function as
an SGD, 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 AGDs/voice prostheses.