How To Use CPT Code 92603

CPT 92603 describes the diagnostic analysis and programming of a cochlear implant for patients aged 7 years or older. This article will cover the official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes and billing examples.

1. What is CPT Code 92603?

CPT 92603 can be used to describe the diagnostic analysis and programming services provided by a healthcare professional for a cochlear implant in patients aged 7 years or older. This code is used when the provider performs all necessary programming to ensure the proper functioning of the implant and also provides counseling to the patient and their family on the care of the device.

2. Official Description

The official description of CPT code 92603 is: ‘Diagnostic analysis of cochlear implant, age 7 years or older; with programming.’

3. Procedure

1. The healthcare professional 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 magnet is not causing any issues at the implant site and that it is not impeding blood flow.
3. The provider then connects the transmitter, microphone, and cable to the external speech processor.
4. Under computer control, they place the speech processor for programming.
5. The healthcare professional ensures that the stimulator system is functioning correctly and that all electrodes in the cochlea are properly positioned.
6. They adjust the implant settings, such as volume and stimulator, according to the patient’s specific needs.
7. The provider activates the electrodes one by one, assessing the patient’s comfort level throughout the process.
8. They provide counseling to the patient and their family on how to use the external speech processor controls, position the microphone and transmitter, insert batteries, and recharge the system.
9. The healthcare professional instructs the patient and their family to keep a daily record of their experiences with the implant for future reprogramming.
10. Finally, the provider compiles and records all the data.

4. Qualifying circumstances

CPT 92603 is applicable to patients aged 7 years or older who have a cochlear implant. The healthcare professional must perform diagnostic analysis and programming of the implant. This code is not appropriate for patients younger than 7 years old or for initial programming or subsequent testing of a cochlear implant.

5. When to use CPT code 92603

CPT code 92603 should be used when a healthcare professional performs diagnostic analysis and programming for a cochlear implant in a patient aged 7 years or older. It is important to note that this code is not appropriate for patients younger than 7 years old or for initial programming or subsequent testing of a cochlear implant.

6. Documentation requirements

To support a claim for CPT 92603, the healthcare professional must document the following information:

• Patient’s age (must be 7 years or older)
• Details of the diagnostic analysis performed
• Specific programming adjustments made to the cochlear implant
• Counseling provided to the patient and their family
• Instructions given on the care and maintenance of the cochlear implant
• Any additional notes or observations

7. Billing guidelines

When billing for CPT 92603, ensure that the patient is 7 years or older and that the diagnostic analysis and programming of the cochlear implant are performed. This code should not be reported for patients younger than 7 years old or for initial programming or subsequent testing of a cochlear implant. It is important to review the specific guidelines provided by the payer to ensure accurate billing.

8. Historical information

CPT 92603 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. Audiologist performing diagnostic analysis and programming for a cochlear implant in a 10-year-old patient.
2. Otolaryngologist conducting diagnostic analysis and programming for a cochlear implant in a 45-year-old patient.
3. Speech-language pathologist providing counseling and programming for a cochlear implant in a 70-year-old patient.
4. Ear, nose, and throat specialist performing diagnostic analysis and programming for a cochlear implant in a 25-year-old patient.
5. Audiologist adjusting the settings and providing counseling for a cochlear implant in a 60-year-old patient.
6. Otolaryngologist conducting diagnostic analysis and programming for a cochlear implant in a 55-year-old patient.
7. Speech-language pathologist providing counseling and programming for a cochlear implant in a 30-year-old patient.
8. Ear, nose, and throat specialist performing diagnostic analysis and programming for a cochlear implant in a 20-year-old patient.
9. Audiologist adjusting the settings and providing counseling for a cochlear implant in a 65-year-old patient.
10. Otolaryngologist conducting diagnostic analysis and programming for a cochlear implant in a 40-year-old patient.