How To Use CPT Code 92626

CPT 92626 describes the evaluation of auditory function for surgically implanted device(s) candidacy or postoperative status of a surgically implanted device(s) for the first hour. 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 92626?

CPT 92626 can be used to describe the evaluation of auditory function for surgically implanted device(s) candidacy or postoperative status of a surgically implanted device(s) for the first hour. This code is used when a healthcare provider assesses the patient’s auditory functional status, including sound perception, listening ability, orienting movements, and balancing. The evaluation helps determine if the patient is a good candidate for a surgically implanted hearing device or to check the efficacy of a previously implanted hearing device.

2. Official Description

The official description of CPT code 92626 is: ‘Evaluation of auditory function for surgically implanted device(s) candidacy or postoperative status of a surgically implanted device(s); first hour.’

3. Procedure

1. The healthcare provider evaluates the patient’s auditory functional status, including sound awareness, ability to differentiate between varying sound types and intensities, and general hearing ability.
2. The provider also assesses the patient’s listening abilities, especially in noisy environments.
3. Based on the evaluation, the provider determines the efficacy of a previously implanted hearing device or whether the patient is a candidate for one.
4. This code represents the first or only hour of evaluation.

4. Qualifying circumstances

Patients eligible for CPT 92626 are those who require evaluation of their auditory function for surgically implanted device(s) candidacy or postoperative status of a surgically implanted device(s). The evaluation helps determine if the patient is a good candidate for a surgically implanted hearing device or to check the efficacy of a previously implanted hearing device.

5. When to use CPT code 92626

CPT code 92626 should be used when a healthcare provider performs an evaluation of auditory function for surgically implanted device(s) candidacy or postoperative status of a surgically implanted device(s) for the first hour. This code represents the initial or standalone evaluation.

6. Documentation requirements

To support a claim for CPT 92626, the healthcare provider must document the following information:

• Patient’s auditory functional status, including sound perception, listening ability, orienting movements, and balancing
• Evaluation of the efficacy of a previously implanted hearing device or candidacy for a surgically implanted hearing device
• Date and duration of the evaluation
• Specific findings and recommendations based on the evaluation
• Signature of the healthcare provider performing the evaluation

7. Billing guidelines

When billing for CPT 92626, ensure that the evaluation is performed for the first hour and is related to the candidacy or postoperative status of surgically implanted device(s). There are no specific guidelines regarding reporting CPT 92626 with other codes. However, additional evaluation time beyond the first hour can be reported using CPT code 92627. It is important to follow the guidelines provided by the payer and accurately document the services provided.

8. Historical information

CPT 92626 was added to the Current Procedural Terminology system on January 1, 2006. There have been no updates or changes to the code since its addition.

9. Examples

1. Audiologist evaluating the auditory function of a patient to determine their candidacy for a surgically implanted hearing device.
2. Surgeon assessing the postoperative status of a patient with a surgically implanted hearing device.
3. Speech therapist evaluating the auditory processing abilities of a child with communication difficulties.
4. ENT specialist assessing the efficacy of a previously implanted cochlear implant in a patient.
5. Provider evaluating the auditory function of a patient with hearing loss to determine the appropriate management plan.
6. Provider assessing the auditory functional status of a patient with balance issues to determine the underlying cause.
7. Audiologist evaluating the auditory function of a patient with tinnitus to determine the appropriate treatment approach.
8. Provider assessing the auditory processing abilities of a patient with a history of learning difficulties.
9. Surgeon evaluating the candidacy of a patient for a surgically implanted osseointegrated hearing device.
10. Provider assessing the postoperative status of a patient with a surgically implanted bone-anchored hearing aid.