How To Use CPT Code 92550

CPT 92550 is a global service code for tympanometry and reflex threshold measurements, used to evaluate the middle and inner ear for various ear diseases. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes, and examples of CPT 92550 procedures.

1. What is CPT 92550?

CPT 92550 is a global service code that encompasses both tympanometry and reflex threshold measurements. These tests are performed to evaluate the middle and inner ear for various ear diseases. Tympanometry is used to determine problems in the middle ear by creating variations of air pressure in the ear canal, while reflex threshold measurements, also known as acoustic reflex tests (ART), measure the contraction of the stapedius muscle in response to a loud sound.

2. 92550 CPT code description

The official description of CPT code 92550 is: “Tympanometry and reflex threshold measurements.”

3. Procedure

The 92550 procedure involves the following steps:

  1. The provider places a probe into the patient’s ear canal to perform tympanometry.
  2. The probe changes the pressure in the ear, generates tones, and measures the sound that reflects back.
  3. The provider performs an acoustic reflex test (ART) by placing an earphone on one ear and the probe on the other.
  4. The provider switches the earphone and probe to test the other ear.
  5. A total of four test conditions and reflex measurements are obtained for each ear at different levels of frequencies.

4. Qualifying circumstances

Patients who are eligible to receive CPT code 92550 services are those experiencing symptoms or conditions related to middle or inner ear diseases, such as hearing loss, ear pain, or balance issues. The provider must determine that both tympanometry and reflex threshold measurements are necessary for a comprehensive evaluation of the patient’s ear health.

5. When to use CPT code 92550

It is appropriate to bill the 92550 CPT code when both tympanometry and reflex threshold measurements are performed on a patient to evaluate the middle and inner ear for various ear diseases. The provider must determine that both tests are necessary for a comprehensive evaluation of the patient’s ear health and document the medical necessity of the tests in the patient’s medical record.

6. Documentation requirements

To support a claim for CPT 92550, the following information must be documented in the patient’s medical record:

  • Patient’s symptoms or conditions related to middle or inner ear diseases
  • Provider’s determination that both tympanometry and reflex threshold measurements are necessary for a comprehensive evaluation of the patient’s ear health
  • Results of the tympanometry and reflex threshold measurements, including the four test conditions and reflex measurements for each ear at different levels of frequencies
  • Provider’s interpretation of the test results and any subsequent treatment recommendations

7. Billing guidelines

When billing for CPT code 92550, keep in mind the following guidelines and rules:

  • This service includes testing of both ears. Use modifier 52 (reduced services) if a test is applied to one ear instead of both.
  • E/M services are included in 92550 and the component codes, 92567 and 92568.
  • Do not report 92550 in conjunction with 92567 or 92568.

8. Historical information

CPT 92550 was added to the Current Procedural Terminology system on January 1, 2010. There have been no updates to the code since its addition.

9. Similar codes to CPT 92550

Five similar codes to CPT 92550 and how they differentiate from CPT 92550 are:

  • CPT 92567: This code is for tympanometry only, without reflex threshold measurements.
  • CPT 92568: This code is for acoustic reflex testing only, without tympanometry.
  • CPT 92557: This code is for a comprehensive audiometry threshold evaluation and speech recognition.
  • CPT 92552: This code is for pure tone audiometry (threshold); air only.
  • CPT 92553: This code is for pure tone audiometry (threshold); air and bone.

10. Examples

Here are 10 detailed examples of CPT code 92550 procedures:

  1. A patient with sudden hearing loss in both ears undergoes tympanometry and reflex threshold measurements to evaluate the middle and inner ear.
  2. A patient with chronic ear infections and persistent ear pain undergoes tympanometry and reflex threshold measurements to assess the middle and inner ear.
  3. A patient with vertigo and balance issues undergoes tympanometry and reflex threshold measurements to evaluate the middle and inner ear for possible causes.
  4. A patient with a history of exposure to loud noises undergoes tympanometry and reflex threshold measurements to assess the middle and inner ear for potential damage.
  5. A patient with tinnitus undergoes tympanometry and reflex threshold measurements to evaluate the middle and inner ear for possible causes.
  6. A patient with a family history of hearing loss undergoes tympanometry and reflex threshold measurements to assess the middle and inner ear for early signs of hearing loss.
  7. A patient with a history of ear surgery undergoes tympanometry and reflex threshold measurements to evaluate the middle and inner ear for post-surgical complications.
  8. A patient with a history of recurrent otitis media undergoes tympanometry and reflex threshold measurements to assess the middle and inner ear for potential complications.
  9. A patient with a history of barotrauma undergoes tympanometry and reflex threshold measurements to evaluate the middle and inner ear for potential damage.
  10. A patient with a history of otosclerosis undergoes tympanometry and reflex threshold measurements to assess the middle and inner ear for progression of the disease.

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