How To Use CPT Code 92591

CPT 92591 describes the assessment and selection of hearing aids for patients who may benefit from amplification in both ears. 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 92591?

CPT 92591 can be used to describe the examination and selection of hearing aids for patients who may benefit from amplification in both ears. This code is used when a healthcare provider assesses the patient’s hearing and determines if the use of hearing aids is appropriate. The provider will discuss the patient’s medical history, current medications, and symptoms of hearing loss. They will also examine the patient’s ears, including the ear canal and eardrum, to identify any conditions that may be causing the hearing impairment. Based on the assessment, the provider will recommend the type of hearing aids that would best suit the patient’s condition.

2. Official Description

The official description of CPT code 92591 is: ‘Hearing aid examination and selection; binaural.’

3. Procedure

1. The healthcare provider takes a detailed medical history, including information about the patient’s current medications, childhood diseases, and symptoms of hearing loss.
2. The provider examines the patient’s ears using an otoscope, a device that magnifies the structures in the ear. This examination includes inspecting the ear canal and eardrum to identify any conditions that may be causing the hearing impairment.
3. Based on the assessment, the provider recommends appropriate treatment options. If no medical or surgical solution is feasible, the provider recommends the type of hearing aids that would best meet the patient’s condition.

4. Qualifying circumstances

Patients eligible for CPT 92591 are those who may benefit from the use of hearing aids in both ears. The provider must assess the patient’s hearing and determine if amplification is necessary. The examination and selection of hearing aids are performed for patients with hearing loss or impairment. The service is inherently bilateral, so there is no need to append modifier 50, Bilateral procedure, to the code.

5. When to use CPT code 92591

CPT code 92591 should be used when a healthcare provider performs an examination and selection of hearing aids for a patient who may benefit from amplification in both ears. This code is appropriate when the provider assesses the patient’s hearing, discusses their medical history and symptoms, and examines their ears to determine the need for hearing aids. It is important to note that CPT 92591 is not appropriate for examinations performed on only one ear, in which case CPT 92590 should be used instead.

6. Documentation requirements

To support a claim for CPT 92591, the healthcare provider must document the following information:

• Patient’s medical history, including current medications, childhood diseases, and symptoms of hearing loss
• Results of the examination, including findings from the inspection of the ear canal and eardrum
• Recommendations for treatment, including the type of hearing aids that would best suit the patient’s condition

7. Billing guidelines

When billing for CPT 92591, ensure that the examination and selection of hearing aids are performed for both ears. There is no need to append modifier 50, Bilateral procedure, to the code as it is inherently bilateral. It is important to note that CPT 92591 should not be reported with other codes such as CPT 92566, 92567, or 92568, as these codes represent different services. It is recommended to review the specific guidelines provided by the payer to ensure accurate billing and reimbursement.

8. Historical information

CPT 92591 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates to the code since its addition.

9. Examples

1. Audiologist performing an examination and selection of hearing aids for a patient with bilateral hearing loss.
2. ENT specialist assessing a patient’s hearing and recommending appropriate hearing aids for both ears.
3. Hearing aid specialist examining a patient’s ears and discussing the benefits of binaural amplification.
4. Primary care physician referring a patient to an audiologist for a comprehensive hearing aid assessment for both ears.
5. Pediatrician evaluating a child’s hearing and determining the need for hearing aids in both ears.
6. Geriatrician performing a hearing aid examination and selection for an elderly patient with bilateral hearing impairment.
7. Otolaryngologist conducting an assessment of a patient’s hearing and recommending binaural amplification.
8. Speech-language pathologist collaborating with an audiologist to assess a patient’s hearing and select appropriate hearing aids for both ears.
9. Neurologist referring a patient with bilateral hearing loss to an audiologist for a comprehensive hearing aid examination and selection.
10. Family physician discussing the benefits of binaural amplification and referring a patient to an audiologist for further evaluation.