Billing New Otoacoustic Emission Codes What’s the appropriate billing code for an evoked otoacoustic emissions evaluation? The answer, as of Jan. 1, 2012, is different from what audiologists are used to. Three changes to otoacoustic emission (OAE) screening and evaluation codes in the Current Procedural Terminology (CPT, © American Medical Association) affect how audiologists bill ... Bottom Line
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Bottom Line  |   March 01, 2012
Billing New Otoacoustic Emission Codes
Author Notes
  • Neela Swanson, associate director of health care economics and coding, can be reached at nswanson@asha.org.
    Neela Swanson, associate director of health care economics and coding, can be reached at nswanson@asha.org.×
Article Information
Hearing & Speech Perception / Hearing Disorders / Practice Management / Bottom Line
Bottom Line   |   March 01, 2012
Billing New Otoacoustic Emission Codes
The ASHA Leader, March 2012, Vol. 17, 3-45. doi:10.1044/leader.BML1.17032012.3
The ASHA Leader, March 2012, Vol. 17, 3-45. doi:10.1044/leader.BML1.17032012.3
What’s the appropriate billing code for an evoked otoacoustic emissions evaluation? The answer, as of Jan. 1, 2012, is different from what audiologists are used to.
Three changes to otoacoustic emission (OAE) screening and evaluation codes in the Current Procedural Terminology (CPT, © American Medical Association) affect how audiologists bill for the procedures. A new code defines OAE screening; changes to two existing codes differentiate between “limited” and “comprehensive” evaluation based on the number of frequencies tested.
The changes are causing a lot of uncertainty. Audiologists are asking ASHA, as well as the Academy of Doctors of Audiology and the American Academy of Audiology, which codes to use for which procedures. The three organizations developed an online resource of frequently asked questions to help clarify OAE coding issues.
Below are excerpted questions and answers from that list that address the following CPT codes:
  • 92558 (new): Evoked otoacoustic emissions, screening (qualitative measurement of distortion product or transient evoked otoacoustic emissions), automated analysis.

  • 92587 (revised): Distortion product evoked otoacoustic emissions, limited evaluation (to confirm the presence or absence of hearing disorder, 3–6 frequencies), or transient evoked otoacoustic emissions, with interpretation and report.

  • 92588 (revised): Distortion product evoked otoacoustic emissions, comprehensive diagnostic evaluation (quantitative analysis of outer hair cell function by cochlear mapping, minimum of 12 frequencies), with interpretation and report.

Q: When should I use 92558 (OAE screening)?
If the provider relies only on the equipment to determine the pass/fail response, without further clinical assessment and/or interpretation, use code 92558.
Q: What is the difference between 92587 (limited evaluation) and the new screening code (92558)?
The new screening code (92558) is an automated pass/fail test, which may be performed by support personnel. CPT 92587 requires three to six distinct frequencies, interpretation, and a statement of the presence or absence of hearing loss and the frequencies affected.
Q: For CPT code 92588 (comprehensive evaluation), the new descriptor says a “minimum of 12 frequencies.” Does that mean I need to perform 12 frequencies in total or 12 frequencies per ear?
The code requires a minimum of 12 frequencies to be completed for each ear.
Q: What if my equipment does not have the capability to perform 12 distinct frequencies?
Providers performing anything fewer than 12 frequencies must report code 92587.
Q: For CPT codes 92587 and 92588, may a technician perform the test and an audiologist do the interpretation and report?
Yes. As with all codes with both a technical component and a professional component (92540–92546, 92548, and 92585), if the test is performed by a technician under the direct supervision of a physician or by a physician, the test can be filed with the -TC modifier. If an audiologist is performing the interpretation and report, he or she would file the claim with the -26 modifier (professional component). Under Medicare, services provided by a technician cannot be filed by an audiologist or with the audiologist’s National Provider Identifier (NPI). Members should consult other third-party payers for specific guidance regarding audiologist supervision of technicians.
Q: What is required with “interpretation and report”?
The provider must include the interpretation of the test results in the patient’s medical record. A printout from the equipment by itself is not considered a report.
For more guidance, audiologists should consult with facility billing departments as well as with third-party payers. Payers may dictate the use of specific diagnosis codes, modifiers, and coverage determinations. Members also should consider consulting with equipment distributors for questions regarding specific equipment protocols and capabilities.
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March 2012
Volume 17, Issue 3