Primary Care Coding Alert

Get an additional $18 for a threshold exam

You can stop unfamiliar audiometry terms from slowing down your screening and threshold test coding if you follow these three steps. 1. Look at the Test's Equipment You should first check the audiometry instruments your FP uses.

Why: Each audiometry test requires different equipment. A screening test (92551, Screening test, pure tone, air only) uses relatively inexpensive equipment, says Rudy Tacoronti, MD, director of occupational medicine for DeKalb Health Systems in Decatur, Ga. "On the other hand, a threshold test (92552, Pure tone audiometry [threshold]; air only) requires specialized equipment."

Your family physician (FP) may own both types of equipment. If he uses a handheld "noise maker," he performs a screening, Tacoronti says. In this case, you should report 92551.

But if your FP uses an audiometer that can adjust the decibel level down to zero and measure multiple frequencies, he performs a threshold test. You should code this exam with 92552. Your FP might refer patients to specialized clinics for the more in-depth test (92552). 2. Pinpoint the Number of Intensities The next clue you should look for is how complicated the test is.

Here's how: Check the number of intensities your FP records. In a screening, the examiner typically places earphones on the patient and asks him to respond to tones at a single intensity (loudness) across several frequencies (pitches), says Susan Beam, CCC/A, an audiologist with Genesis Health Care System at Bethesda Hospital in Zanesville, Ohio. But with 92552, the physician expands the testing to include multiple intensities.

Note: For a guide to audiologic testing terms, see "Decibels, Hertz: Here's How to  Keep Audiometry Terms Straight".

Screening example: An FP sets his machine at 25 decibels (dB) and varies the frequencies to get a response to all sounds in both ears. The test does not involve multiple intensities. So, you should use 92551 for a screening.

Threshold example: A physician uses increasingly lower intensities to determine that at 4,000 hertz (Hz), the patient's lowest limit of hearing is 15 dB, and 10 dB at
3,000 Hz, but only 5 dB at 2,000 Hz, etc. In this case, you should report 92552. The FP tests the patient's hearing at different loudnesses (dB).  

Visual clue: The audiogram, a chart that shows the levels the patient can hear, may help you choose the right code. If your FP records the test results as one level or writes "screening" in the chart, he performed a single-intensity test, 92551, Beam says. But if the [...]