Does E1902 require prior authorization?

No, E1902 does not require prior authorization (high confidence). Covered without prior authorization.

`E1902`, Communication board, non-electronic augmentative or alternative communication

HCPCS/CPT

No Prior Auth Required

Covered without prior authorization (high confidence)

Documentation required: forward the SLP's written evaluation and recommendation to the treating physician prior to ordering the SGD.
Documentation must include a formal written SLP evaluation prior to delivery containing the specified elements (current impairment, assessment of alternatives, goals/treatment options, device/accessory rationale, training schedule, demonstration of cognitive/physical ability, and upgrade justification).
A copy of the SLP's written evaluation and recommendation must be forwarded to the treating physician before ordering the SGD.

Type and number of symbols/pictures and/or words used with each device trial;and
Extent to which individual can independently navigate the device.
Augmentative and alternative communication devices with digitized or synthesized speech output are consideredmedically necessarywhenallof the following criteria A through C are met,andwhen applicable, criteria D or E are met:
The device has been recommended by the individualâs physicianandlicensed speech language pathologist who have each conducted and documented a thorough assessment which includes all of the following information:Medical diagnosis, physiological description of the underlying disorder, description of functional limitation, nature and severity of speech or communication impairment, and prognosis for improvement (or deterioration);andMedical justification for the device and documentation that a non- [...]
Medical diagnosis, physiological description of the underlying disorder, description of functional limitation, nature and severity of speech or communication impairment, and prognosis for improvement (or deterioration);and
Medical justification for the device and documentation that a non-electronic communication device (such as a communication board) is inadequate to meet the individualâs functional communication needs;and

ANTHEM-CG-DME-07, Augmentative and Alternative Communication (AAC) Devices with Digitized or Synthesized Speech Output

BCBSIL-DME104.009, Speech Generating Devices (SGD)

BCBSMT-DME104.009, Speech Generating Devices (SGD)

BCBSNM-DME104.009, Speech Generating Devices (SGD)

BCBSOK-DME104.009, Speech Generating Devices (SGD)