How To Use CPT Code 92601

CPT 92601 describes the diagnostic analysis and programming of a cochlear implant in a patient under the age of 7. 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 92601?

CPT 92601 can be used to describe the diagnostic analysis and programming of a cochlear implant in a patient who is younger than 7 years old. This code is used when a healthcare provider analyzes the cochlear implant, performs all necessary programming, and provides counseling to the patient and their family on how to properly care for the device.

2. Official Description

The official description of CPT code 92601 is: ‘Diagnostic analysis of cochlear implant, patient younger than 7 years of age; with programming.’

3. Procedure

1. The healthcare provider begins by placing a transmitter magnet opposite the cochlear implant’s receiver, which is located under the patient’s skin.
2. They ensure that the patient is comfortable and that the magnet is not causing any issues at the implant site.
3. The provider connects the transmitter, microphone, and cable to the external speech processor and places it under computer control for programming.
4. They verify that the stimulator system is functioning properly and that all electrodes in the cochlea are correctly positioned.
5. The provider adjusts the implant settings, such as volume and stimulation, according to the patient’s specific needs.
6. They activate the electrodes one by one, assessing the patient’s comfort level throughout the process.
7. The provider counsels the patient’s family on how to use the external speech processor controls, position the microphone and transmitter, insert batteries, and recharge the system.
8. They instruct the family to keep a daily record of the patient’s experiences with the implant for future reprogramming.
9. The provider compiles and records all relevant data.

4. Qualifying circumstances

CPT 92601 is applicable when a patient under the age of 7 has a cochlear implant that requires diagnostic analysis and programming. The healthcare provider must perform all necessary programming and provide counseling to the patient and their family on how to care for the device.

5. When to use CPT code 92601

CPT code 92601 should be used when a healthcare provider is performing the initial diagnostic analysis and programming of a cochlear implant in a patient under the age of 7. It is important to note that subsequent testing on patients under 7 should be reported using CPT code 92602, while codes 92603-92604 are used for patients 7 and older.

6. Documentation requirements

To support a claim for CPT 92601, the healthcare provider must document the following information:

• Patient’s age and diagnosis requiring the cochlear implant
• Details of the diagnostic analysis performed
• Specific programming adjustments made to the cochlear implant
• Date and duration of the procedure
• Counseling provided to the patient and their family
• Instructions given for care and maintenance of the cochlear implant
• Any additional relevant information or observations

7. Billing guidelines

When billing for CPT 92601, ensure that the patient is under the age of 7 and that the diagnostic analysis and programming of the cochlear implant are performed. It is important to follow the specific guidelines for reporting this code and to consider any additional tips provided by coding experts. For subsequent testing on patients under 7, use CPT code 92602. For patients 7 and older, refer to codes 92603-92604.

8. Historical information

CPT 92601 was added to the Current Procedural Terminology system on January 1, 2003. There have been no updates or changes to the code since its addition.

9. Examples

1. A healthcare provider performs a diagnostic analysis and programs a cochlear implant in a 5-year-old patient.
2. A child under the age of 7 receives a cochlear implant, and the healthcare provider conducts the necessary programming and counseling for the patient and their family.
3. A 6-year-old patient with a cochlear implant undergoes a diagnostic analysis and programming session with their healthcare provider.
4. A provider performs the initial programming of a cochlear implant in a 4-year-old patient, ensuring that the device is functioning optimally.
5. A 3-year-old patient receives a cochlear implant, and the healthcare provider performs the diagnostic analysis and programming required for proper functioning.
6. A healthcare provider analyzes and programs a cochlear implant in a 2-year-old patient, providing counseling to the family on how to care for the device.
7. A 1-year-old patient with a cochlear implant undergoes a diagnostic analysis and programming session with their healthcare provider.
8. A provider performs the initial programming of a cochlear implant in a 6-month-old patient, ensuring that the device is functioning properly.
9. A 5-year-old patient receives a cochlear implant, and the healthcare provider conducts the necessary diagnostic analysis and programming, as well as counseling for the patient and their family.
10. A healthcare provider analyzes and programs a cochlear implant in a 4-year-old patient, providing guidance on how to properly care for the device.