How To Use CPT Code 92577

CPT 92577 describes a functional hearing test known as the Stenger test, which is used to determine if a patient has unilateral hearing loss or is simulating a hearing loss. This article will provide an overview of CPT code 92577, including its official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes, and examples.

1. What is CPT Code 92577?

CPT 92577 is a code that represents the Stenger test, a functional hearing test used to assess unilateral hearing loss or pseudohypacusis. During this test, the provider delivers words of the same frequency simultaneously to both ears and increases the intensity level in the worse ear to gauge the patient’s response. By observing the patient’s reactions, the provider can determine if the hearing loss is genuine or if the patient is simulating the condition.

2. Official Description

The official description of CPT code 92577 is: ‘Stenger test, speech.’ This test involves delivering words of the same frequency simultaneously to both ears and increasing the intensity level in the worse ear to assess the patient’s response.

3. Procedure

1. The provider administers the Stenger test by delivering words of the same frequency simultaneously to both ears.
2. The provider determines the hearing threshold of both ears.
3. The provider delivers the speech to both ears at a level above the threshold in the good ear and below the level of the good ear in the suspected deficient ear.
4. The provider increases the intensity level of the suspected deficient ear and observes the patient’s response.
5. If the patient continues to respond when the level of the suspected deficient ear exceeds the signal in the good ear, it indicates genuine hearing loss.
6. If the patient stops responding when the level of the suspected deficient ear exceeds the signal in the good ear, it suggests simulation of hearing loss.

4. Qualifying circumstances

CPT 92577 is used when a patient is suspected of having unilateral hearing loss or pseudohypacusis. Unilateral hearing loss refers to hearing loss in one ear, while pseudohypacusis involves the fabrication or exaggeration of hearing loss symptoms. This test helps differentiate between genuine hearing loss and simulated conditions. It is important to note that psychogenic hearing loss, which is caused by mental or emotional disorders or trauma, can also be a qualifying circumstance for this test.

5. When to use CPT code 92577

CPT code 92577 should be used when a provider performs the Stenger test to assess unilateral hearing loss or pseudohypacusis. It is appropriate to bill this code when the test is administered to both ears. If the test is only applied to one ear instead of both, modifier 52 (reduced services) should be used to indicate the reduced scope of the test.

6. Documentation requirements

When reporting CPT code 92577, the provider must document the following information:

• Patient’s symptoms or suspected condition necessitating the Stenger test
• Details of the test procedure, including the delivery of words of the same frequency to both ears and the intensity levels used
• Patient’s responses during the test, indicating genuine hearing loss or simulation
• Any additional relevant findings or observations
• Provider’s signature and credentials

7. Billing guidelines

When billing for CPT code 92577, ensure that the Stenger test is performed as described in the official description. It is important to note that this code should not be reported with other codes, as it represents a specific test. Additionally, modifier 52 should be used if the test is applied to only one ear instead of both. It is crucial to follow the specific guidelines provided by payers and coding authorities for accurate billing and reimbursement.

8. Historical information

CPT code 92577, the Stenger test, 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. A patient presents with complaints of hearing loss in their left ear. The provider performs the Stenger test by delivering words of the same frequency simultaneously to both ears and increasing the intensity level in the left ear. The patient continues to respond even when the level in the left ear exceeds the signal in the right ear, indicating genuine hearing loss in the left ear.
2. A patient claims to have significant hearing loss in both ears. The provider administers the Stenger test and observes that the patient stops responding when the intensity level in the suspected deficient ear exceeds the signal in the good ear. This suggests that the patient is simulating the hearing loss.
3. A patient with a history of psychogenic hearing loss undergoes the Stenger test to assess their condition. The provider delivers words of the same frequency to both ears and increases the intensity level in the suspected deficient ear. The patient continues to respond, indicating genuine hearing loss.
4. A child is brought in for a hearing evaluation due to concerns about their hearing abilities. The provider performs the Stenger test, delivering words of the same frequency to both ears and increasing the intensity level in the suspected deficient ear. The child stops responding when the level in the suspected deficient ear exceeds the signal in the good ear, suggesting simulation of hearing loss.
5. A patient presents with inconsistent hearing loss symptoms. The provider conducts the Stenger test, delivering words of the same frequency to both ears and increasing the intensity level in the suspected deficient ear. The patient continues to respond, indicating genuine hearing loss.