Getting Reimbursement: Past Efforts Shape Future Strategies Reimbursement for fluency treatment continues to be an ongoing process. Why won’t health plans cover treatment for stuttering? Why must clinicians appeal denials by providing large amounts of documentation and supporting research, only to be denied at the next appeal level? To understand current reimbursement surrounding stuttering treatment, and ... Article
Article  |   September 01, 2003
Getting Reimbursement: Past Efforts Shape Future Strategies
Author Affiliations & Notes
  • Janet McCarty
    ASHA
Article Information
Fluency Disorders / Practice Management / Articles
Article   |   September 01, 2003
Getting Reimbursement: Past Efforts Shape Future Strategies
SIG 4 Perspectives on Fluency and Fluency Disorders, September 2003, Vol. 13, 22-23. doi:10.1044/ffd13.1.22
SIG 4 Perspectives on Fluency and Fluency Disorders, September 2003, Vol. 13, 22-23. doi:10.1044/ffd13.1.22
Reimbursement for fluency treatment continues to be an ongoing process. Why won’t health plans cover treatment for stuttering? Why must clinicians appeal denials by providing large amounts of documentation and supporting research, only to be denied at the next appeal level? To understand current reimbursement surrounding stuttering treatment, and to try to make improvements, a review of past advocacy efforts and a look to the future is in order. Let’s examine attempts to reclassify diagnostic codes and look forward to emerging action plans under ASHA’s Focused Initiative: Health Care Reimbursement.
Dissatisfaction with diagnostic codes used to classify stuttering led to ASHA requesting that the National Committee on Vital and Health Statistics re-classify the ICD-9 diagnostic code 307.0 (stammering and stuttering). In November 1997, ASHA requested the code for stuttering to be removed from its current chapter, Chapter 5: “Neurotic Disorders, Personality Disorders, and Other Nonpsychotic Mental Disorders,” and placed in the more appropriate chapter, “Symptoms, Signs, and Ill-Defined Conditions.” The requested change in the code was based on mounting research evidence that stuttering is physiologically based.
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