Correct Billing is Key for Hearing and Vision Srceening Tests
Published on Fri Oct 01, 1999
Hearing and vision tests are often conducted as part of preventive medical services. But does that mean that they cant be billed in addition to the preventive medical services codes (99381-99385, 99391-99395)? You can and you should bill themespecially the hearing screens, for which there are several specific codes. Will you get paid for them? That depends, as is so often the case, on your carriers policies about these tests. In most cases, the tests will be paidproviding you bill correctly for them. Here are the techniques used by our sources.
Billing Tips for Hearing Screens
The three main hearing screens used by primary-care pediatricians are CPT 92551 (screening test, pure tone, air only), 92552 (pure tone audiometry [threshold]; air only), and 92555 (speech audiometry threshold), says Susan Beam, CCC/A, audiologist with Genesis Health Care System at Bethesda Hospital in Zanesville, OH.
Here is how these two screens work: Pure tone (92551) means that the child has ear phones on and the tone is set at 25 decibels. Then the frequencies are changed, and you test how well the child hears at the different frequencies, Beam explains. The intensity (decibel level) doesnt change, but the frequency does. The threshold test (92552) involves changing both intensity and frequency. The frequency is set at four different levels, and then you see what the lowest level intensity is at which the child can hear (hence the threshold). Speech audiometry (92555) involves a machine which delivers word soundsagain it is a threshold test, and you see how low the intensity can be and still have the child recognize the sound.
How well do these codes pay? According to HealthCare Consultants of America 1999 Physicians Fee and Coding Guide, 92551 pays from $25 to $30, 92552 from $29 to $35, and 92555 from $20 to $26. Are they included in the preventive medical services exam? No way. You should be able to bill for these, without a modifier, and get paid. As Beam puts it, the only way primary care pediatricians will get paid for using these codes is to charge for themafter all, they are screening codes, meant for use for referral purposes. If they pass, thats great, she says. If they dont, that tells you to refer them for more testing.
You should use the same diagnosis code for the hearing test as for the preventive medicine visit: V20.2 (routine infant or child health check).
Note: You cannot bill for any audiologic function test if you are using a tuning fork or a whispered voice. These are considered part of the general otorhinolaryngologic services and are not reported separately, according to CPT.
Vision Screening Coding Tactics
Vision testing is a [...]
