How To Use CPT Code 92552

CPT 92552 is a code used for pure tone audiometry (threshold) air only testing, assessing a patient’s hearing with a series of tones at varying intensities. This article will cover the description, procedure, qualifying circumstances, billing guidelines, documentation requirements, historical information, similar codes, and examples of CPT 92552.

1. What is CPT 92552?

CPT 92552 is a medical billing code used to describe a specific type of hearing test known as pure tone audiometry (threshold) air only. This test is performed to assess a patient’s hearing ability by presenting them with a series of tones at varying intensities and determining the lowest threshold at which they can hear. The code is used by medical coders and billers to accurately document and bill for this service.

2. 92552 CPT code description

The official description of CPT code 92552 is: “Pure tone audiometry (threshold); air only.”

3. Procedure

The 92552 procedure involves the following steps:

1. The patient is placed in a soundproof booth with speakers or fitted with headphones.
2. The provider presents the patient with a series of tones at varying levels of intensity.
3. The patient’s responses to different sounds are recorded, and the softest level at which the patient can hear is established.
4. This is an air conduction test, as the sound waves travel through the outer ear and middle ear to the inner ear.
5. When headphones are used, each ear can be tested separately. If headphones cannot be used, the patient is placed in a soundproof room, which does not allow for testing of each ear separately.
6. Pure tone refers to a basic single-frequency sound, a sine wave, a repeating pattern of oscillation at a constant amplitude.

4. Qualifying circumstances

Patients who are eligible to receive CPT code 92552 services include those experiencing hearing difficulties, those with a history of hearing loss, or those who require a hearing assessment for occupational or other reasons. The test may also be performed as part of a routine hearing screening or as a follow-up to a failed hearing screening.

5. When to use CPT code 92552

It is appropriate to bill the 92552 CPT code when a provider performs a pure tone audiometry (threshold) air only test to assess a patient’s hearing ability. This code should be used for the technical component of the service only and should not be appended with modifier 26, Professional component. The service includes testing of both ears, and modifier 52, Reduced services, should be used if the test is applied to one ear instead of both.

6. Documentation requirements

To support a claim for CPT 92552, the following information should be documented:

• Patient’s medical history, including any history of hearing loss or hearing difficulties.
• Reason for the hearing test, such as occupational requirements, routine screening, or follow-up to a failed hearing screening.
• Details of the procedure, including the use of headphones or a soundproof booth, and whether both ears were tested separately or together.
• Results of the test, including the patient’s responses to different sounds and the softest level at which the patient can hear.
• Any recommendations for further testing or treatment based on the test results.

7. Billing guidelines

When billing for CPT code 92552, it is important to follow the appropriate guidelines and rules. The code represents the technical component of the service only, so modifier 26, Professional component, should not be appended. If the test is applied to one ear instead of both, use modifier 52, Reduced services. Additionally, it is essential to study the descriptions of codes 92550 to 92597, Audiologic Function Tests, to determine which code to report when assessing a patient’s hearing.

8. Historical information

CPT 92552 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates to the code since its addition.

9. Similar codes to CPT 92552

Five similar codes to CPT 92552 and how they differentiate from CPT 92552 are:

1. CPT 92553: This code is used for pure tone audiometry (threshold); air and bone, which includes both air and bone conduction testing.
2. CPT 92555: This code is for speech audiometry threshold testing, which assesses a patient’s ability to hear and understand speech.
3. CPT 92556: This code is for speech audiometry (speech in noise) testing, which evaluates a patient’s ability to hear and understand speech in the presence of background noise.
4. CPT 92557: This code is for comprehensive audiometry threshold evaluation and speech recognition, which includes pure tone air and bone conduction testing, speech audiometry threshold testing, and speech recognition testing.
5. CPT 92550: This code is for tympanometry and reflex threshold measurements, which assess the function of the middle ear and the acoustic reflex.

10. Examples

Here are 10 detailed examples of CPT code 92552 procedures:

1. A patient with a history of hearing loss undergoes a pure tone audiometry (threshold) air only test to assess their current hearing ability.
2. A child experiencing difficulty hearing in school is tested using CPT 92552 to determine if they have a hearing impairment.
3. An adult patient with a family history of hearing loss undergoes a CPT 92552 test as part of a routine hearing screening.
4. A patient who failed a hearing screening at their workplace undergoes a CPT 92552 test to further assess their hearing ability.
5. A patient with a history of ear infections undergoes a CPT 92552 test to determine if their hearing has been affected.
6. An elderly patient experiencing difficulty hearing in noisy environments undergoes a CPT 92552 test to assess their hearing ability.
7. A patient with tinnitus undergoes a CPT 92552 test to determine if they have an underlying hearing impairment.
8. A patient who has been exposed to loud noise in their occupation undergoes a CPT 92552 test to assess their hearing ability.
9. A patient with a history of ototoxic medication use undergoes a CPT 92552 test to determine if their hearing has been affected.
10. A patient with a sudden onset of hearing loss undergoes a CPT 92552 test to assess the severity of their hearing impairment.