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Audiology diagnosis code problem

  1. Default Audiology diagnosis code problem
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    I code for an ENT office. Our audiologist codes her herself. We have been getting quite a few denials and they all seem to have one code in common: 388.8. She uses this as ear fullness. UHC especially does not like this code and does not have it on their "approved" list. But yet, it still gets coded.
    Does anyone have any suggestions on what other code we could be using. Unfortunately I am not that familiar with audiology. I want to bring some information with me when I meet with my office concerning this issue.

    (Ex. Patient came in postsurgery for a post-op visit. Patient complained of sense of fullness in his ear, along with popping and ear feels plugged. Tympanogram was done (92567))

    Thanks in advance or your help with this!!

  2. #2
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    Stuart Sailfish Chapter
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    First of all, what was the post op visit for? was it for eustation tube dysfunction? was it an ENT related surgery?

    Secondly: United healthcare has there own rules as far as diagnosis codes go with hearing tests. there web site lists them.

    Our ENT's normally perform a TYMP (92567) and a (92557) after a patient has had tubes placed the dx codes are usally, 381.81. the ear fullness and popping could be due to eustation tube dysfunction.

    Hope this helps.
    Last edited by Candice_Fenildo; 03-26-2009 at 04:02 PM.
    Candice Fenildo, CPC, CPMA, CPC-I, CPB, CENTC, CRHC, AAPC Fellow
    AAPC Chapter Association Board of Directors ( Chair)
    Region 6, Wisconsin, Minnesota, Illinois, Indiana, Michigan, Ohio
    772-342-6976
    Candice.Fenildo@appcca.org

    "Nothing is stronger than the heart of a volunteer"

  3. #3
    Default coder925
    I'm getting rejections on hearing tests for all 10 of the sensoneural hearing loss codes for 92557, 92567 & 92568. (389.10-18) Is anyone else? What do you use? 92700?

    Info/experience Please...
    Thanks.
    Anita

  4. #4
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    Stuart Sailfish Chapter
    Posts
    867
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    OUr practice has not had ANY rejections on Hearing Test codes AT ALL. O would highly recommend putting a phone call in to your provider rep for that specific carrier.
    Candice Fenildo, CPC, CPMA, CPC-I, CPB, CENTC, CRHC, AAPC Fellow
    AAPC Chapter Association Board of Directors ( Chair)
    Region 6, Wisconsin, Minnesota, Illinois, Indiana, Michigan, Ohio
    772-342-6976
    Candice.Fenildo@appcca.org

    "Nothing is stronger than the heart of a volunteer"

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