Revenue Cycle Insider

Question: What is the appropriate code to use for conducting hearing screenings on newborns or infants? When we use 92551, we receive a denial.

Alabama Subscriber

Answer: Although 92551 (Screening test, pure tone, air only) is indeed an appropriate code when performing a screening test for hearing issues, 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.” This would be the reason for the denial of your claims.

Instead, you should look to the following codes depending on the type of screening test that was performed:

• 92558 (Evoked otoacoustic emissions, screening (qualitative measurement of distortion product or transient evoked otoacoustic emissions), automated analysis) — This examination evaluates the functionality of the cochlea’s hair cells by using pairs of tones at designated frequencies.
• 92650 (Auditory evoked potentials; screening of auditory potential with broadband stimuli, automated analysis) — This test measures the patient’s response to auditory stimuli. The electrical reactions, also referred to as auditory evoked potentials, are documented and the outcomes are produced via automated evaluation. These automated analyses give a simple pass-or-fail result. Patients who do not pass the screening may need to perform additional testing to determine their degree of hearing loss.

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