Gain Proper Payment for Hearing Screening and Testing
Published on Wed Nov 01, 2000
Pediatricians are under pressure to screen their patients for hearing problems, but do not always know how to use the CPT codes that apply. One of the problems is that some codes pay very well, but require equipment that the pediatrician doesnt have and isnt likely to get. If the pediatrician or his or her biller tries to bill these codes inappropriately, even though the cause is ignorance and not greed, the insurance company could realize that there is a problem during an audit. But by knowing the differences between the various audiometry codes, pediatricians can avoid this problem.
First, there is a difference between a hearing screen and a diagnostic hearing test, says Susan Beam, CCC/A, an audiologist with Genesis Health Care System at Bethesda Hospital in Zanesville, Ohio. A screen is a test on an apparently normal baby or child to find out if there might be a problem, she explains. If the child fails the screen, further testing is done.
In some states, including Ohio, all newborns are screened without any actual test at all, but with a paper form filled out by each new parent. If there are any indications of risk prematurity or various prenatal illnesses, for example then the baby is called in for a screening.
On infants, the screening test we use is an otoacoustic emission test, says Beam. The code for this test is CPT 92587 (evoked otoacoustic emissions; limited [single stimulus level, either transient or distortion products]). In the normal healthy ear, a noise is produced, she explains. We have found that we can evoke that noise. A little probe put into the ear sends two sounds simultaneously. The ear gives an echo that the probe picks up and the computer analyzes. With transient noise, test results can be achieved with a softer stimulus.
If the baby fails the 92587 screen, Beam brings the baby in a month later for a repeat. Then, if the infant fails that test as well, the baby goes to the childrens hospital for an auditory evoked potential test. This test is not a screen. In fact, it doesnt test hearing at all. Instead, it examines the nerve pathway from the cochlea back to the brain stem. The CPT code for this test is 92585 (auditory evoked potentials for evoked response audiometry and/or testing of the central nervous system). During the test, electrodes are attached to each mastoid or earlobe, to the forehead, and to the top of the head. Then, earphones (or little foamy plugs) are used to deliver a stimulus either clicks or tones. Many hospitals do this test [...]
