How To Use CPT Code 92625

CPT 92625 describes the assessment of tinnitus, including pitch, loudness matching, and masking. 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 92625?

CPT 92625 can be used to describe the assessment of tinnitus, which is a phantom hearing perception generated within the patient’s head. Tinnitus is a symptom, not a disease. The provider evaluates the intensity and pitch of the tinnitus using sound generators and tests both ears to determine the loudness and frequency of the abnormal sound heard by the patient.

2. Official Description

The official description of CPT code 92625 is: ‘Assessment of tinnitus (includes pitch, loudness matching, and masking).’ It is important to note that CPT code 92625 should not be reported in conjunction with CPT code 92562, and if the assessment is performed on only one ear, modifier 52 should be appended to indicate the reduced service.

3. Procedure

1. The provider tests the patient’s ears for tinnitus, which is an abnormal sound heard by the patient due to an ear anomaly.
2. The provider evaluates the intensity of the tinnitus, also known as loudness matching, by asking the patient to identify the loudness of the tinnitus based on the loudness of tones presented by the provider.
3. The provider also determines the pitch of the tinnitus, also known as pitch matching or frequency matching, by asking the patient to identify which external pitch best matches the tinnitus sound heard in their ears.
4. The provider may use masking techniques to help determine the characteristics of the tinnitus, such as its frequency and loudness.
5. If the assessment is performed on only one ear, modifier 52 should be appended to indicate the reduced service.

4. Qualifying circumstances

CPT 92625 is used for the assessment of tinnitus, which is an abnormal sound heard by the patient due to an ear anomaly. The provider tests the patient’s ears for tinnitus and evaluates the intensity and pitch of the sound using sound generators. This code represents testing on both ears, so if the provider tests only one ear, modifier 52 should be appended to indicate the reduced service.

5. When to use CPT code 92625

CPT code 92625 should be used when the provider performs an assessment of tinnitus, including pitch, loudness matching, and masking. It is important to note that this code should not be reported in conjunction with CPT code 92562, which is used for diagnostic hearing evaluation.

6. Documentation requirements

To support a claim for CPT code 92625, the provider should document the following information:

• The patient’s symptoms and complaints related to tinnitus
• The results of the assessment, including the intensity and pitch of the tinnitus
• The specific techniques used, such as loudness matching and pitch matching
• If the assessment is performed on only one ear, modifier 52 should be documented

7. Billing guidelines

When billing for CPT code 92625, ensure that the assessment of tinnitus is performed and documented. This code should not be reported in conjunction with CPT code 92562, which is used for diagnostic hearing evaluation. If the assessment is performed on only one ear, modifier 52 should be appended to indicate the reduced service.

8. Historical information

CPT code 92625 was added to the Current Procedural Terminology system on January 1, 2005. There have been no updates to the code since its addition.

9. Examples

1. A provider assesses a patient with tinnitus, performing pitch and loudness matching to determine the characteristics of the abnormal sound heard by the patient.
2. A patient complains of ringing in their ears, and the provider evaluates the intensity and pitch of the tinnitus using sound generators.
3. A provider tests a patient’s ears for tinnitus, using masking techniques to help determine the frequency and loudness of the abnormal sound.
4. A patient reports hearing a constant buzzing sound in their ears, and the provider performs an assessment to determine the intensity and pitch of the tinnitus.
5. A provider evaluates a patient’s tinnitus, performing pitch matching to identify the external pitch that best matches the abnormal sound heard by the patient.
6. A patient presents with roaring sounds in their ears, and the provider assesses the intensity and pitch of the tinnitus using sound generators.
7. A provider tests a patient’s ears for tinnitus, performing loudness matching to determine the loudness of the abnormal sound heard by the patient.
8. A patient complains of static noise in their ears, and the provider evaluates the intensity and pitch of the tinnitus using sound generators.
9. A provider assesses a patient with tinnitus, performing pitch and loudness matching to determine the characteristics of the abnormal sound heard by the patient.
10. A patient reports hearing a high-pitched ringing sound in their ears, and the provider performs an assessment to determine the intensity and pitch of the tinnitus.