Tinnitus Intervention Over the last 15 years, the field of tinnitus evaluation and management has evidenced major advances in its base of knowledge. Notable advances include the use of PET scans to identify a localized site for tinnitus in the brain, as well as the discovery of associations between noise-induced hearing loss ... Bottom Line
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Bottom Line  |   February 01, 2003
Tinnitus Intervention
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Hearing Disorders / Bottom Line
Bottom Line   |   February 01, 2003
Tinnitus Intervention
The ASHA Leader, February 2003, Vol. 8, 3. doi:10.1044/leader.BML1.08022003.3
The ASHA Leader, February 2003, Vol. 8, 3. doi:10.1044/leader.BML1.08022003.3
Over the last 15 years, the field of tinnitus evaluation and management has evidenced major advances in its base of knowledge. Notable advances include the use of PET scans to identify a localized site for tinnitus in the brain, as well as the discovery of associations between noise-induced hearing loss and tinnitus and between hyperacusis and tinnitus. Other developments include discovery of a correspondence between perception of chronic tinnitus and chronic pain, the introduction of tinnitus handicap scales, and a greater understanding of the role played by the brain in interpreting auditory information. These developments have altered the way in which tinnitus is conceptualized and have yielded a variety of treatment strategies. However, reimbursement for audiological services involving tinnitus intervention remains a concern.
Which diagnostic code (ICD-9-CM) should be used to classify “Tinnitus” as the health-related condition?
A. The ICD-9-CM code for tinnitus is 388.3 (388.30 tinnitus, unspecified; 388.31 subjective tinnitus; 388.32 objective tinnitus).
Which procedure (CPT) code should be used for tinnitus assessment?
A. Use CPT code 92557 (comprehensive audiometry) with modifier 22 for the tinnitus-evaluation component (92557-22). By using modifier 22 (unusual procedural services), the audiologist is able to designate that the service provided is greater than that usually provided for the listed procedure. Modifier 22 produces an automatic review or audit by payers, so supporting documentation must be attached to the claim. In addition, don’t expect 22 to be honored for extra payment if it is used too frequently—remember, it is to be used for unusual services only. If approved, payment for 22 may be an additional 20%–50% of the allowable rate for the procedure performed.
Which CPT code should be used when evaluating a client with a tinnitus masker?
A. The evaluation procedure should be coded as CPT 92590 (hearing aid examination and selection: monaural) or 92591 (hearing aid examination: binaural).
A tinnitus masker should be coded using the Level II Health Care Procedure Coding System National Codes (HCPCS codes) for hearing aids, which are required for reporting most medical services and supplies provided to Medicare and Medicaid patients and by most private payers.
Hearing services fall under V5000–V5999. (You can find these codes on ASHA’s Web site.)
Can the various interventions used for the treatment of tinnitus be reimbursed?
A. For the rehabilitation evaluation, use CPT code 92506 (evaluation of speech, language, voice, communication, auditory processing, and/or aural rehabilitation status). For intervention, use 92507 (treatment of speech, language, voice, communication, and/or auditory processing disorder), which includes aural rehabilitation.
Where can I find more information about CPT codes and HCPCS?
A. The American Medical Association (AMA) CPT and HCPCS books are available through the AMA Press (call 800-621-8335). The Coders’ Desk Reference, designed for the lay person, is available through Ingenix Companies (call 800-765-6588). ASHA’s Private Health Plans Handbook also contains a list of the CPT codes most commonly used by members. This product is available through ASHA Product Sales (call 888-498-6699).
For answers to additional questions you may have about modifiers or reimbursement, e-mail reimbursement@asha.org.
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February 2003
Volume 8, Issue 2