How To Use CPT Code 92604

CPT 92604 describes the diagnostic analysis and subsequent reprogramming of a cochlear implant in patients aged 7 years or older. 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 92604?

CPT 92604 can be used to describe the diagnostic analysis and subsequent reprogramming of a cochlear implant in patients aged 7 years or older. This code is used when a healthcare provider checks the functionality of a previously placed cochlear implant, adjusts the settings, and provides counseling to the patient and/or their family on proper care of the device.

2. Official Description

The official description of CPT code 92604 is: ‘Diagnostic analysis of cochlear implant, age 7 years or older; subsequent reprogramming.’

3. Procedure

1. The healthcare provider checks the functionality of a previously placed cochlear implant in a patient aged 7 years or older.
2. The provider measures and adjusts the external transmitter and reprograms the internal stimulator of the cochlear implant.
3. The patient’s experiences with the current settings are reviewed and adjustments are made to ensure comfort and optimal performance.
4. The provider ensures that the magnet isn’t causing any issues at the implant site and that all electrodes in the cochlea are properly positioned.
5. The implant settings, such as volume and stimulator, are adjusted according to the patient’s specific needs.
6. The provider activates the electrodes in succession while assessing the patient’s comfort level.
7. Counseling is provided to the patient and/or their family on how to use the external speech processor controls, position the microphone and transmitter, insert batteries, and recharge the system.
8. The patient is instructed to keep a daily record of their experiences with the implant for future reprogramming.
9. Data is compiled and recorded by the provider.

4. Qualifying circumstances

CPT 92604 is performed on patients aged 7 years or older who have previously received a cochlear implant. The procedure involves diagnostic analysis and subsequent reprogramming of the implant. The provider ensures that the implant is working properly, adjusts the settings, and provides counseling on proper care of the device.

5. When to use CPT code 92604

CPT code 92604 should be used when a healthcare provider performs diagnostic analysis and subsequent reprogramming of a cochlear implant in a patient aged 7 years or older. It is important to note that CPT code 92604 should not be reported in addition to CPT code 92603.

6. Documentation requirements

To support a claim for CPT 92604, the healthcare provider must document the following information:

• Patient’s age (must be 7 years or older)
• Confirmation of a previously placed cochlear implant
• Date of the procedure
• Specific adjustments made to the external transmitter and internal stimulator
• Review of the patient’s experiences with the current settings
• Confirmation of proper positioning of the electrodes and absence of any issues at the implant site
• Details of the counseling provided to the patient and/or their family
• Instructions given for daily record-keeping of the patient’s experiences with the implant
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT 92604, ensure that the procedure is performed on a patient aged 7 years or older and involves the diagnostic analysis and subsequent reprogramming of a cochlear implant. It is important to note that CPT code 92604 should not be reported in addition to CPT code 92603. No specific billing guidelines or modifiers are mentioned in the provided information.

8. Historical information

CPT 92604 was added to the Current Procedural Terminology system on January 1, 2003. There have been no updates to the code since its addition.

9. Examples

1. Audiologist performing diagnostic analysis and subsequent reprogramming of a cochlear implant in a 10-year-old patient.
2. Otolaryngologist adjusting the settings of a previously placed cochlear implant in a 45-year-old patient and providing counseling on proper care of the device.
3. Speech-language pathologist reviewing the patient’s experiences with a cochlear implant and making adjustments to improve performance in a 70-year-old patient.
4. Ear, nose, and throat specialist ensuring the proper functioning of a cochlear implant and counseling the patient’s family on how to use the external speech processor controls in a 60-year-old patient.
5. Audiologist reprogramming the internal stimulator of a cochlear implant and instructing the patient on how to insert batteries and recharge the system in a 55-year-old patient.
6. Otolaryngologist measuring and adjusting the external transmitter of a cochlear implant in a 30-year-old patient and providing guidance on positioning the microphone and transmitter.
7. Speech-language pathologist activating the electrodes of a cochlear implant in succession and assessing the patient’s comfort level in a 20-year-old patient.
8. Ear, nose, and throat specialist ensuring the proper positioning of electrodes in the cochlea and confirming the absence of issues at the implant site in a 50-year-old patient.
9. Audiologist compiling and recording data from the diagnostic analysis and subsequent reprogramming of a cochlear implant in a 65-year-old patient.
10. Otolaryngologist counseling the patient and their family on how to keep a daily record of experiences with the cochlear implant for future reprogramming in a 75-year-old patient.