Coding Guide for Audiogram CPT code

Basics of Audiogram CPT code

Medicare policy on billing for audiology services. CMS indicated that qualified technicians, including those trained in the Academy’s oto-tech program, can only perform diagnostic audiology tests (under direct physician supervision) that have a technical and professional component. In such cases, the technicians can only perform the technical component of the test.  However, be sure to check with your local Medicare contractor for coding guidelines for audiogram cpt code.

Tests that have a split professional and technical component (TC/ -26) most likely do not likely require an audiologist. For codes that do have a split, an oto-tech (or other practitioners that furnishes the technical component) may perform the technical component of the service under direct physician supervision (note that for CPT codes with a split, the physician, non-physician practitioner or audiologist must perform the professional component of the tests). However, as mentioned previously, be sure to check with your local Medicare contractor for guidelines. 

Read also: Coding guide for Mohs Micrographic CPT codes

List of some Audiogram CPT code

The audiologist evaluates central auditory function. Central auditory processes are the auditory mechanisms that are responsible for what the brain does with what the ears hear. Many individuals have no difficulty detecting the presence of sound but have other auditory difficulties related to central auditory processes, such as understanding conversation in noisy environments, following complex directions, and learning new vocabulary words. There are two major categories of tests: behavioral tests and electrophysiologic tests. The behavioral tests can be monotic or dichotic. Monotic tests use a single stimulus presented to one ear at a time or tests in which two stimuli are presented to one ear.

Dichotic tests use the same stimulus applied to both ears. Testing may be performed on only one ear (monaural) or both ears simultaneously (binaural). Specific types of tests that can be given include monaural low-redundancy speech tests, dichotic speech tests, temporal patterning tests, and binaural interaction tests. The audiologist selects the appropriate battery of central auditory function tests after evaluating the patient using routine hearing tests. Central auditory function tests are used to differentiate central from peripheral hearing loss and occasionally to identify the site of a lesion in the central nervous system. CPT code 92620 is reported for the first 60 minutes of the evaluation and CPT code 92621  for each additional 15 minutes.

The patient is seen face to face by a physician or other qualified health care provider for a pre-implant candidacy evaluation or for a post-implant evaluation of a surgically implanted device. The evaluation includes listening inventories and phonetic discrimination testing to determine the patient’s level of sound perception and sound discrimination ability. CPT code 92626 is report for the first hour and CPT code 92627 for each additional 15 minutes.

92626 Evaluation of auditory rehabilitation status; first hour