Otolaryngology Coding Alert

Find solutions to just-discovered logistical problems. It's been a tumultuous nine months getting your office ready for Medicare's required direct reporting of qualified audiologists- diagnostic services. These answers will help smooth some of the bumps still ahead. Which Audio Codes Can a Tech Provide? You can easily identify eight possible codes that oto-techs may perform in Transmittal 84. "The technical components of certain audiological diagnostic tests i.e., tympanometry (92567) and vestibular function tests (e.g., 92541) that do not require the skills of an audiologist may be performed by a qualified technician or by an audiologist, physician, or nonphysician practitioner acting within their scope of practice." The transmittal specifies that technicians can perform certain audiological diagnostic tests that do not require the skills of an audiologist or physician while the patient is being tested to interpret the test results and respond, interpreting the future direction of the testing. The one test listed in the transmittal as meeting this requirement is tympanometry. In addition, technicians can provide the technical portion of all vestibular function tests. The transmittal gives 92541 as an example of a code in that family. The full vestibular family is 92541-92546. Transmittal Vocab You Need: "i.e." is an abbreviation for the Latin words "id est" or "that is," according to Merriam-Webster's Dictionary. The abbreviation "e.g." is Latin for "exempli gratia," which means "for example." Transmittal 84 also states, "With the exception of screening tests and tympanograms, audiologic function tests with medical diagnostic evaluation require the skills of an audiologist." So you have 92567, plus screening codes 92551 and 92560, which Medicare does not cover. Medicare's public files might give you a clue to additional codes, suggests the CMS official who authored Transmittal 84. "Refer to the technical components in the physician fee schedule practice expense and/or TC codes," the official tells Otolaryngology Coding Alert. In addition to vestibular codes (92541-92546), three additional audiological diagnostic codes (92585, 92587, and 92588) have technical components on the 2008 fee schedule. In other words, under physician or qualified nonphysician practitioner supervision, a technician may be able to perform the technical component of 92567, 92541-92546, 92585, 92587, and 92588 provided the physician or NPP is responsible for all clinical judgment and for the appropriate provision of the service. Final word: Check with your carrier, recommends the CMS official. "Some of the contractors have developed (or may be developing) policies that interpret the transmittals." Does E/M Require 25? When an ENT provides an office visit for a patient and orders an audiological diagnostic test that a qualified audiologist in the same group performs on the same day, you should report the E/M and the test under each provider's NPI. "I have heard that the claims [...]