How To Use CPT Code 92563

CPT 92563 describes a tone decay test, which is a hearing assessment that measures the time it takes for a tone to decrease in volume. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes and billing examples.

1. What is CPT Code 92563?

CPT 92563 is used to report a tone decay test, which is an evaluation of the transmission of nerve impulses from the ear. This test measures the difference in time between when a tone is emitted and when it is heard, providing information about the presence and likely origin of a hearing disorder.

2. Official Description

The official description of CPT code 92563 is: ‘Tone decay test: Hearing assessment involving the perception of a tone that decreases over time.’

3. Procedure

1. The provider places earphones on the patient.
2. A continuous tone is presented to the patient at a volume above their lowest hearing level for one minute.
3. The provider measures the time for which the tone is audible.
4. If necessary, the provider may increase the volume needed for the patient to hear the tone and record the difference.
5. The test results are compared to the patient’s established norms to determine the presence of a hearing disorder and its likely origin.

4. Qualifying circumstances

A tone decay test is performed when there is a need to assess problems in the transmission of nerve impulses from the ear. This test is typically conducted for patients who may have a hearing disorder. The provider must use their professional judgment to determine the appropriateness of performing the test based on the patient’s symptoms and medical history.

5. When to use CPT code 92563

CPT code 92563 should be used when a tone decay test is performed to evaluate the transmission of nerve impulses from the ear. It is important to note that this code represents the technical component of the service only, and modifier 26 (Professional component) should not be appended.

6. Documentation requirements

To support a claim for CPT 92563, the provider must document the following information:

• Patient’s symptoms and medical history indicating the need for a tone decay test
• Details of the test procedure, including the duration of the test and the volume levels used
• Test results and comparison to the patient’s established norms

7. Billing guidelines

When reporting CPT 92563, ensure that the test is performed as described in the procedure section. Modifier 26 should not be appended to this code, as it represents the technical component only. It is important to review payer-specific guidelines for any additional requirements or restrictions.

8. Historical information

CPT 92563 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates or changes to the code since its addition.

9. Examples

1. Audiologist performs a tone decay test to assess a patient’s hearing disorder.
2. Provider conducts a tone decay test on a patient with suspected auditory nerve dysfunction.
3. A tone decay test is performed on a patient with a history of noise-induced hearing loss.
4. Provider evaluates a patient’s hearing disorder by conducting a tone decay test.
5. Tone decay test is performed on a patient with complaints of tinnitus and hearing loss.
6. Provider uses a tone decay test to assess the presence of a hearing disorder in a pediatric patient.
7. Audiologist performs a tone decay test on a patient with a history of ear infections.
8. Provider conducts a tone decay test to evaluate a patient’s auditory processing disorder.
9. Tone decay test is performed on a patient with a suspected conductive hearing loss.
10. Provider uses a tone decay test to assess the effectiveness of a patient’s hearing aids.