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24.5.16.3 Procedure Codes for ACD Systems and Accessories
ACDs and Access Devices
A digitized speech device, sometimes referred to as a "whole message" speech output device, utilizes words or phrases that have been recorded by someone other than the ACD system user for playback upon command of the ACD system user. Use procedure codes J/L-E2500, J/L-E2502, J/L-E2504, and J/L-E2506 for the rental or purchase of a digitized speech device.
A synthesized speech device is a technology that translates a user's input into device-generated speech using algorithms representing linguistic rules. Users of synthesized speech ACD systems are not limited to pre-recorded messages, but can independently create messages as their communication needs dictate.
Some synthesized speech devices require that the user make physical contact with a keyboard, touch screen, or other display containing letters. Use procedure code J/L-E2508 for the rental or purchase of a synthesized speech device.
Other synthesized devices allow multiple methods of message formulation through letters, words, pictures, or symbols. Such devices also allow for multiple methods of access including direct physical contact with a keyboard or touch screen; and one or more tools that aid in direct selection, including joystick, head mouse, optical pointer, infrared and light pointers, scanning device, or morse code. These synthesized speech devices are reimbursed with procedure code J/L-E2510.
Synthesized speech language generating devices with multiple methods of message formulation and multiple methods of device access are reimbursed with procedure code J/L-E2510 and the corresponding modifier TG (Intermediate level) or TF (Complex/High tech level) as indicated below.
Reimbursement for the rental or purchase of synthesized speech generating devices that have multiple methods of message formulation and multiple methods of device access may be considered based on the following levels of access devices:
• Minimum level-basic access device, such as a joystick for clients with good gross and fine motor control (no modifier required).
•Medium level-gross motor control access devices, such as a switch or large button, for clients with good gross motor skills, but poor fine motor extremity skills (use modifier TF).
•Maximum level-fine motor and head control access devices, such as a laser or infrared pointer, for clients with good fine motor head control, but poor fine and gross motor extremity skills (use modifier TG).
Items included in the reimbursement for an ACD system and not reimbursed separately include, but are not limited to, the following:
•ACD.
•Basic essential software (except for software purchased specifically to enable a client owned computer or personal digital assistant [PDA] to function as an ACD system).
•Requests for ACD software may be considered for prior authorization if the software is more cost effective than an ACD system.
•If an ACD system is more cost-effective than adapting the client owned laptop PC or PDA, an ACD system will be considered for prior authorization instead of the ACD software.
•If software is purchased, installation of the program and technical support are included in the reimbursement for the software. Rental of ACD system software is not a benefit. Speech generating software is identified with procedure code J-E2511.
Note: Either an ACD system or ACD software for a client-owned laptop or desktop PC or PDA may be authorized, but not both.
•Batteries.
•Battery charger, power supplies, A/C, and/or other adapters.
•Interface cables.
•Adequate memory to allow for system expansion within a five year time frame.
•All basic operational training necessary to instruct the client and family/caregiver(s) in the use of the ACD system.
•Manufacturer's warranty.
•Interconnects.
•Sensors.
•Moisture guard.
•Access device when necessary.
•Mounting device when necessary.
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