ASHA Questions Use of Audiology Codes for Otogram Troubling reports surfaced over the holidays that some health care billing contains audiology procedure codes when the automated Otogram™ is used. In response, e-mails flew among members of the ASHA Health Care Economics Committee (HCEC) which advocates on coding issues—and ASHA’s audiology listserv buzzed with member concerns and comments. According ... ASHA News
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ASHA News  |   January 01, 2005
ASHA Questions Use of Audiology Codes for Otogram
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Hearing Disorders / ASHA News & Member Stories / ASHA News
ASHA News   |   January 01, 2005
ASHA Questions Use of Audiology Codes for Otogram
The ASHA Leader, January 2005, Vol. 10, 3. doi:10.1044/leader.AN2.10012005.3
The ASHA Leader, January 2005, Vol. 10, 3. doi:10.1044/leader.AN2.10012005.3
Troubling reports surfaced over the holidays that some health care billing contains audiology procedure codes when the automated Otogram™ is used. In response, e-mails flew among members of the ASHA Health Care Economics Committee (HCEC) which advocates on coding issues—and ASHA’s audiology listserv buzzed with member concerns and comments.
According to The Hearing Health Network, the Otogram performs automated comprehensive audiometry, tympanometry/acoustic reflex and otoacoustic emission. Its manufacturer claims that Otogram (TM) procedures are reimbursable by Medicare and other insurers and do not require new Current Procedural Terminology (CPT) codes.
ASHA has initiated discussions with the AMA CPT Committees and payer groups to provide clarification on appropriate coding for automated procedures. “Payers may be unaware that bills received for Otogram services are not for services performed by trained professionals. The tests are reported with the audiology codes. Thus, the payers have no reason to question the billing,” said Bob Fifer, an HCEC member and ASHA representative to the relevant AMA committee. “Protocols that involve only a testing instrument without professional input in the execution of the procedure should not be reported using the current audiology code series,” said Fifer. “The reimbursement rates used by payers like Medicare are based in substantial part on a professional’s time and skill.”
Audiologists who have their claims denied because the third party payer has already reimbursed procedures performed by an Otogram™ should contact the payer and describe the difference between the two types of services.
To hear what other audiologists are saying about the Otogram, subscribe to ASHA’s audiology listserv (members only). Under Connect to Your Colleagues, click on Our E-mail List. For more information on the Otogram™ contact Steven White at swhite@asha.org or Pam Mason at pmason@asha.org. Also watch for our new audiology-only news page of The ASHA Leader, which launches Feb. 8.
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January 2005
Volume 10, Issue 1