Revenue Cycle Insider

Question: What is the correct CPT^® code for conducting hearing screenings on newborns? We’ve attempted using 92551, but so far, this has resulted in denied claims. Which code should we use instead?

AAPC Forum Participant

Answer: Although 92551 (Screening test, pure tone, air only) is used to determine the presence or absence of a possible hearing issue, it’s inappropriate to use this code for a hearing screening conducted on a newborn or infant, and here’s why: CPT^® Assistant, Volume 24, Issue 8, explains that “while this procedure may be used for persons of various ages, it is not appropriate to use this code to report hearing screenings performed on newborns and infants.”

Instead, you’ll look to one of the following codes based on the type of screening being performed:

• 92558 (Evoked otoacoustic emissions, screening (qualitative measurement of distortion product or transient evoked otoacoustic emissions), automated analysis): This test assesses the condition of the cochlea (specifically the hair cell function) by using pairs of tones at designated frequencies. This method is used to examine hearing impairments in infants and young children who may not be able to participate effectively in other types of tests.
• 92650 (Auditory evoked potentials; screening of auditory potential with broadband stimuli, automated analysis): This method tests the patient’s reaction to sound stimuli. The electrical reactions, also referred to as auditory evoked potentials, are documented, and the outcomes are produced through automated evaluation.

These automated analyses give a pass-or-fail result. Patients who fail the screening may need to perform additional testing to determine their degree or type of hearing loss.

Make note: If you are billing the above services along with a well visit, you’ll need to use modifier 59 (Distinct procedural service) to indicate that the preventive service and the auditory testing were performed separately.

Lindsey Bush, BA, MA, CPC, Production Editor, AAPC