Legislation in Action
Our Legislative Connections
Changing the Future Through Advocacy
Lobbyist Updates
OSLHA Advocacy Representatives
For more information or questions on legislative or advocacy issues, contact your OSLHA GAC reps anytime!
- Amy Tepper, Ed.D., CCC-SLP
- Chelsea Bailey, OSLHA Executive Director
- Maggie Kettler, AuD, FAAA
To call or write your legislator, visit: www.legislature.ohio.gov
Current Legislative/Regulatory Activity
Children & Infant Mortality Prevention
The “Strong Foundations Act” is being promoted to address Ohio’s abysmal maternal and infant mortality rates. Rep. Andrea White (R-Kettering) said Tuesday. “It’s risky business to have a baby in our state. Ohio has some of the worst infant and maternal mortality rates in the entire nation,” White told the House Finance Committee during sponsor testimony on HB7 (White-Humphrey). The bill was reported out of the House Families and Aging Committee in June, and some provisions of the bill were included in the recent state budget proposal. The bill is being considered by the House Finance Committee because it includes a $37.5 million appropriation in FY24 and an $18.5 million appropriation in FY25 for
various programs to improve the health of mothers and infants throughout the state.
ASL Services Added to Ohio's Suicide & Crisis Prevention Lifeline
Ohio’s 988 Suicide and Crisis Lifeline has added American Sign Language services for deaf and hard of hearing callers.
To connect directly to a trained 988 Lifeline counselor in ASL, callers who are Deaf, DeafBlind, DeafDisabled, Hard of Hearing, or Late-Deafened
can click the “ASL Now” button on 988lifeline.org and follow the prompts.
Direct dialing to 988 from a videophone will be available in the coming weeks, and in the meantime, ASL callers can call 1-800-273-TALK (8255) from their videophone to reach ASL services.
Retroactive Corrections Being Accepted for Unintentional CCI Edit that Prevented Same-Day Billing of Videofluoroscopic Swallowing Study by SLPs and Radiologists
In a recent communication, CMS noted that corrections have been made to an unintentional edit that prevented same-day billing of 92611 and 74230. We are pleased to report that with the reversal of the CCI edit, Speech-Language Pathologists (SLPs) and Radiologists will once again be appropriately reimbursed for each distinctly different portion of their professional collaboration during the videofluoroscopic swallowing study (VFSS). Billing adjustments will be retroactive to January 1, 2020, and the wording will be implemented as soon as technically possible in a future edit update!!
CMS further clarified that claims for same-day billing of 92611 and 74230 must include a modifier to note that the services are separate and distinct. This means that claims for VFSS should include 92611 first on the claim, as the “column 1” code, followed by 74230 with the modifier -59 (or subcategory modifiers) appended. Additional information on the use of CCI-associated modifiers is available on ASHA’s website.
Effective January 1, 2020, the Centers for Medicare & Medicaid Services (CMS) implemented a new National Correct Coding Initiative (CCI) edit that prevents same-day billing of Current Procedural Terminology (CPT ® American Medical Association) codes 74230 (Radiologic examination, swallowing function, with cineradiography/videoradiography) and 92611 (Motion fluoroscopic evaluation of swallowing function by cine or video recording).
Speech-language pathologists (SLPs) typically collaborate with radiologists to perform the videofluorscopic swallowing study (VFSS), also called the modified barium swallowing (MBS) study. CPT codes 74230 and 92611 describe the work required to identify the medical diagnosis by the radiologist (74230) and to evaluate swallowing function by the SLP (92611). With the new CCI edit in place, SLPs and radiologists will not be appropriately reimbursed for each distinctly different portion of their professional collaboration during the VFSS.
ASHA is engaging with CMS and the contractor that manages the NCCI program to resolve this issue. In the meantime, ASHA recommends providers continue to submit same-day claims for 92611 and 74230. Because the new CCI edit lists 92611 as the “column 1” code, it should be placed first on the claim, followed by 74230. This means that 92611 should be processed for payment, but 74230 will be denied. If CMS reverses the CCI edit, all claims submitted since January 1, 2020, can be reprocessed for payment of 74230.
Background
The NCCI (or more commonly, CCI) is an automated edit system to control specific procedure code pairs that can or cannot be reported on the same day. CMS developed the system for use in all Medicare Part B (outpatient) and Medicaid claims. See CCI Edits for Speech-Language Pathology Services for additional information on same-day billing restrictions.
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