Audiology billing Guide - CPT code list

Policy Definition

Audiology is the study of hearing and hearing disorders and includes habilitation and rehabilitation for individuals who have hearing loss

Provider Billing Guidelines and Documentation
Coding3

Code Description Comments

92550–92588 Audiometric tests Bill once with a count of one

92597 Evaluation for use and/or fitting of voice prosthetic device to supplement oral speech

92601–92604 Diagnostic analysis of cochlear implant; with programming; subsequent reprogramming

92605 Evaluation for prescription of non speech generating augmentative and alternative communication device Reimbursed for facility only

92606 Therapeutic service(s) for the use of non speech generating device, including programming and modification

92607–92609 Speech generating and non-speech generating augmentativeand alternative communication device-related services
To bill professional component of service use CPT; to bill DME component, refer to Durable Medical Equipment (DME).

92620, 92621 Evaluation of central auditory function, with report

92625 Assessment of tinnitus

92626 Evaluation of auditory rehabilitation status; first hour

92627 Evaluation of auditory rehab status; ea add’l 15 minutes Bill in conjunction with 92626

92630 Auditory rehabilitation; pre-lingual hearing loss

92633 Auditory rehabilitation; post-lingual hearing loss

 92700 Unlisted otorhinolaryngological service or procedure Submit documentation of services rendered


Modifiers

• When billing for monaural hearing aids, a RT or LT modifier in the second modifier field is required for payment. Claims submitted without the RT or LT modifier may be denied.

• When billing for a binaural hearing aid the RT or LT modifier is not required. Claims submitted with a RT or LT modifier will be denied as inappropriately billed.

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