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Wiki Coding Question

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School2016

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We have been billing 92551 (pure tone hearing exam) with our wellness/preventative visits and using Dx. z00.129. I am noticing now that BCBS is stating it is not a payable Dx.
Does anyone have any info on this?
 
A couple of thoughts - first, 92551 is a test usually administered by an audiologist or ENT specialist with special equipment and is accompanied by a report. This is different from the evaluation of hearing done as part of a wellness exam. If your provider is just doing a hearing check as part of their exam, e.g. with a tuning fork, this is an exam element within the E&M service and probably not appropriate to bill separately. Second, most payers just have a limited number of preventive benefits and may not cover the hearing test just for screening purposes. If this is truly just a screening and there is no symptom that is prompting the exam, then a screening diagnosis code is appropriate, but you'd need to check with your payer policy - it may simply not be a covered benefit for the patient.
 
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