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Coverage criteria policies

Augmentative communication device

These services may or may not be covered by your HealthPartners plan. Please see your plan documents for your specific coverage information. If there is a difference between this general information and your plan documents, your plan will be used to determine your coverage.

Administrative Process

Augmentative communication devices (ACD) or electronic speech aids (ESA) do not require prior authorization.

Coverage

An electronic speech aid is generally covered subject to the indications listed below and per your plan documents.

An augmentative communication device (ACD) is generally not covered as most plans exclude them from coverage.

Indications that are covered

Electronic speech aids are covered for members with a diagnosis of post-laryngectomy, or when the larynx is permanently non-functional, such as post radical neck surgery or radiation. Examples of covered devices for these conditions are an artificial larynx (L8500), a tracheostomy-speaking valve (L8501), tracheo-esophageal voice prosthesis (L8507) or a voice amplifier (L8510).

Indications that are not covered

  1. Synthesized speech devices with dynamic display.
  2. Any equipment to create, replace or augment communication abilities including, but not limited to vocal amplifiers, speech processors, receivers, communication boards, or computer or electronic assisted communication. Codes include, but are not limited to E2500, E2502, E2504, E2506, E2508, E2510, and L8510 (except as described above).

Definitions

Augmentative Communication Device (ACD) - a device used to supplement or replace speech. It may transmit or produce messages or symbols in a way that compensates for a speech impairment/disability. Examples are communication picture books, communication charts, boards and mechanical or electronic devices.

Electronic speech aids – a prosthetic device used by persons who have undergone laryngectomy or persons with a permanently non-functional larynx. One type operates by placing a vibrating head against the throat.  Another amplifies sound waves through a tube which is inserted into the user's mouth.

If available, codes for a procedure, device or diagnosis are listed below for informational purposes only, and do not guarantee member coverage or provider reimbursement. The list may not be all-inclusive.

Codes

Description

E2500

Speech generating device, digitized speech, using pre-recorded messages, less than or equal to eight minutes recording time

E2502

Speech generating device, digitized speech, using prerecorded messages, greater than 8 minutes but less than or equal to 20 minutes recording time

E2504

Speech generating device, digitized speech, using prerecorded messages, greater than 20 minutes but less than or equal to 40 minutes recording time

E2506

Speech generating device, digitized speech, using prerecorded messages, greater than 40 minutes recording time

E2508

Speech generating device, synthesized speech, requiring message formulation by spelling and access by physical contact with the device

E2510

Speech generating device, synthesized speech, permitting multiple methods of message formulation and multiple methods of device access

L8500

Artificial larynx, any type

L8501

Tracheostomy-speaking valve

L8507

Tracheo-esophageal voice prosthesis, patient inserted, any type, each

L8510

Voice amplifier

CPT Copyright American Medical Association. All rights reserved.  CPT is a registered trademark of the American Medical Association.

Products

This information is for most, but not all, HealthPartners plans. Please read your plan documents to see if your plan has limits or will not cover some items. If there is a difference between this general information and your plan documents, your plan documents will be used to determine your coverage. These coverage criteria may not apply to Medicare Products if Medicare requires different coverage. For more information regarding Medicare coverage criteria or for a copy of a Medicare coverage policy contact Member Services at 952-883-7979 or 1-800-233-9645.

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Policy activity

  • 04/01/1998 - Date of origin
  • 04/01/2017 - Effective date
Review date
  • 04/2017

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