Healthcare Fraud Shield’s Latest Post: Understanding Interpretive Services

29 Sep

Healthcare Common Procedure Coding System (HCPCS) codes that start with the letter T are typically used by Medicaid agencies, Managed Care Organizations (MCO) who administer Medicaid programs. HCPCS code T1013 is described as”… Sign language or oral interpretive services, per 15 minutes…[1] This code can be used for patients who either do not speak English or who use sign language as their form of communication. 

Beneficiaries who need interpretive services should contact their appropriate state agency or Managed Care Organization (MCO) to learn more about coverage, the process, requirements, standards for the interpreters and more. Many private health insurers offer free language and interpreter services to their commercial plan members. For example, effective 2012, New York Medicaid (both fee-for-service and managed care) will reimburse for interpretive services.[2]

Documentation Requirements:

As always, check with your respective agencies and plans, but for New York Medicaid beneficiaries, interpreter services should be:·      Documented in the medical record·      Provided during the medical visit·      The interpreter should be employed by or contracted with a Medicaid Provider·      Services my be in person or via telephone[3]

According to Blue Cross and Blue Shield of Minnesota and Blue Plus, “Interpreter services provided to Blue Cross subscribers must be rendered by a registered and rostered interpreter with proper certification (in accordance with Minnesota State Statute Sec.144.058”.)[4]

What to look for?

1)     Excessive time billed for these services as they are time-based codes.

2)     The qualifications for the interpreters; i.e.: Do they meet or not meet any necessary requirements?3)     What other services that were billed for these patients on the same day, which is to look for potential unbundling of services.

If you have any questions or comments, please reach out to SIU@hcfraudshield.com.


REFERENCES

[1]https://www.aapc.com/codes/hcpcs-codes/T1013

[2]https://www.health.ny.gov/health_care/medicaid/program/update/2012/oct12mu.pdf

[3]https://www.health.ny.gov/health_care/medicaid/program/update/2012/oct12mu.pdf

[4]https://provider.publicprograms.bluecrossmn.com/docs/gpp/MN_RP_AddPolicies_InterpretiveServices.pdf?v=202104071953

%d bloggers like this: