Re-evaluation of patient using speech generating devices
HCPCS code
Name of the Procedure:
Common Names: Re-evaluation for Speech Generating Devices, Speech Device Check-up
Technical/Medical Term: HCPCS Code G0199 - Re-evaluation of patient using speech generating devices
Summary
The re-evaluation of a patient using speech-generating devices is a procedure conducted to assess the current effectiveness of a speech device the patient is using. This involves checking the device settings, ensuring it meets the patient’s communication needs, and making necessary adjustments for optimal performance.
Purpose
Medical Conditions/Problems: This procedure is essential for individuals with speech impairments due to conditions such as amyotrophic lateral sclerosis (ALS), cerebral palsy, stroke, traumatic brain injury, or other neurological disorders.
Goals/Expected Outcomes: The primary goal is to ensure the speech-generating device optimally supports the patient’s communication needs, enhancing their ability to interact and express themselves effectively.
Indications
Symptoms/Conditions: Difficulty in communication, changes in speech patterns, reduced effectiveness of the speech device, or reported issues with the device.
Patient Criteria/Factors: Patients currently using a speech-generating device who are experiencing changes in their condition, or the device appears to be malfunctioning, or those undergoing regular scheduled device check-ups.
Preparation
Pre-procedure Instructions: No specific fasting or medication adjustments are usually required. However, patients should bring their speech-generating device and any accessories (e.g., chargers, additional communication aids).
Diagnostic Tests/Assessments: A pre-evaluation questionnaire might be provided to understand any issues the patient is experiencing. No extensive diagnostic tests are generally necessary.
Procedure Description
- Interview and Assessment: The healthcare provider will interview the patient (and caregiver, if applicable) about recent experiences with the device.
- Device Check: A thorough inspection of the speech-generating device, including hardware and software components.
- Performance Evaluation: Assess how well the device is meeting the patient’s current communication needs. This may involve observing the patient using the device in different scenarios.
- Adjustments: Make necessary adjustments to settings, update software, or provide training on device features and functionalities.
- Feedback and Training: Educate the patient and caregivers on any new adjustments and provide strategies for optimal use.
Tools/Equipment: Speech-generating devices, diagnostic software, adjustment tools, and any relevant communication aids.
Anesthesia/Sedation: Not required for this procedure.
Duration
Typically, the procedure takes around 30 minutes to an hour, depending on the complexity of the adjustments needed.
Setting
The procedure is usually performed in an outpatient clinic, a specialized speech and language therapy center, or a hospital's speech therapy department.
Personnel
A speech-language pathologist (SLP) or a specialist in assistive communication devices usually conducts the procedure. In some cases, technical support staff may also be involved.
Risks and Complications
Common Risks: There are minimal physical risks associated with this procedure.
Possible Complications: The main concern would be the patient’s temporary inability to use the device effectively if adjustments are not correctly made. This can be managed with follow-up visits and additional training if needed.
Benefits
Expected Benefits: Improved communication and interaction capabilities.
Realization Time: Benefits can often be observed immediately after the device adjustments are made.
Recovery
Post-Procedure Care: The patient might receive a follow-up call or appointment to ensure the device adjustments are effective.
Expected Recovery Time: No physical recovery time involved, but the patient may need a period to adapt to any new changes made to the device. Regular follow-ups might be scheduled to monitor progress.
Alternatives
Other Treatment Options: Alternative augmentative and alternative communication (AAC) devices, manual communication boards, or speech therapy.
Pros and Cons of Alternatives: Alternatives may not be as effective as a properly adjusted speech-generating device in providing independence and ease of communication.
Patient Experience
During the procedure, the patient might experience periods of non-verbal communication while the device is being adjusted. After the adjustments, they should feel more comfortable and effective in using the device. Pain management is generally not necessary as the procedure is non-invasive. Comfort measures include ensuring the patient understands each step of the process and feels confident in using any new features of the device.