CPT® Code 92567

Official Description

Tympanometry (impedance testing)

Common Language Description

Tympanometry, also known as impedance testing, is a diagnostic procedure utilized to assess the functionality of the middle ear. This test is particularly significant as it measures the compliance or flexibility of the eardrum, which is crucial for proper hearing. By evaluating the movement of the tympanic membrane (eardrum) in response to changes in air pressure, tympanometry aids in identifying various middle ear conditions. These conditions may include the presence of fluid in the middle ear, which can indicate an infection or other issues; negative pressure in the middle ear, which may suggest Eustachian tube dysfunction; perforation of the tympanic membrane, which can affect hearing; disruption of the ossicles, the small bones in the middle ear that transmit sound; and otosclerosis, a condition that can lead to hearing loss due to abnormal bone growth in the ear. During the procedure, a physician typically begins by examining the ear with an otoscope to ensure there are no obstructions or abnormalities. Following this examination, a tympanometry device is carefully inserted into the ear canal. This device applies a controlled amount of air pressure, which alters the pressure within the ear canal, causing the eardrum to move. The resulting movement is captured and displayed on a graph known as a tympanogram. The physician then analyzes the tympanogram to interpret the results, providing valuable insights into the patient's middle ear health.

1. Indications

The indications for performing tympanometry (CPT® Code 92567) include the following conditions and symptoms:

Fluid in the Middle Ear The presence of fluid can indicate an ear infection or other middle ear issues that may affect hearing.
Negative Middle Ear Pressure This condition may suggest Eustachian tube dysfunction, which can lead to discomfort and hearing problems.
Perforation of the Tympanic Membrane A perforated eardrum can result from infection, trauma, or other factors, impacting hearing and ear health.
Disruption of the Ossicles Damage or dislocation of the small bones in the middle ear can hinder sound transmission, leading to hearing loss.
Otosclerosis This condition involves abnormal bone growth in the ear, which can cause hearing impairment and may require further evaluation.

2. Procedure

The procedure for tympanometry involves several key steps that ensure accurate assessment of middle ear function:

Step 1: Otoscopic Examination The physician begins by examining the patient's ear using an otoscope. This examination allows the physician to check for any visible abnormalities, such as earwax buildup, perforations, or signs of infection that may affect the tympanometry results.
Step 2: Insertion of Tympanometry Device After the otoscopic examination, the tympanometry device is carefully placed into the ear canal. This device is designed to create a seal in the ear canal to ensure accurate pressure measurements.
Step 3: Application of Air Pressure The tympanometry device then applies a small amount of air pressure, which alters the pressure within the ear canal. This change in pressure causes the eardrum to move back and forth, allowing for the assessment of its compliance.
Step 4: Recording of Eardrum Movement As the eardrum moves in response to the pressure changes, the device records this movement. The data collected is then displayed on a graph known as a tympanogram, which visually represents the eardrum's response to the applied pressure.
Step 5: Interpretation of Results Finally, the physician reviews the tympanogram to interpret the results. This analysis helps determine the presence of any middle ear conditions and guides further management or treatment if necessary.

3. Post-Procedure

After the tympanometry procedure, there are typically no specific post-procedure care requirements, as the test is non-invasive and does not usually cause discomfort. Patients may resume their normal activities immediately following the test. However, the physician may discuss the results with the patient and recommend any necessary follow-up actions based on the findings. If any abnormalities are detected, further diagnostic tests or treatments may be suggested to address the underlying issues affecting middle ear function.

Short Descr	TYMPANOMETRY
Medium Descr	TYMPANOMETRY
Long Descr	Tympanometry (impedance testing)
Status Code	Active Code
Global Days	XXX - Global Concept Does Not Apply
PC/TC Indicator (26, TC)	7 - Physical Therapy Service, for which Payment may not be Made
Multiple Procedures (51)	0 - No payment adjustment rules for multiple procedures apply.
Bilateral Surgery (50)	2 - 150% payment adjustment does NOT apply.
Physician Supervisions	02 - Procedure must be performed under the direct supervision of a physician.
Assistant Surgeon (80, 82)	0 - Payment restriction for assistants at surgery applies to this procedure...
Co-Surgeons (62)	0 - Co-surgeons not permitted for this procedure.
Team Surgery (66)	0 - Team surgeons not permitted for this procedure.
Diagnostic Imaging Family	99 - Concept Does Not Apply
APC Status Indicator	STV-Packaged Codes
Type of Service (TOS)	K - Hearing Items and Services
Berenson-Eggers TOS (BETOS)	T2D - Other tests - other
MUE	1
CCS Clinical Classification	220 - Ophthalmologic and otologic diagnosis and treatment

AB	Audiology service furnished personally by an audiologist without a physician/npp order for non-acute hearing assessment unrelated to disequilibrium, or hearing aids, or examinations for the purpose of prescribing, fitting, or changing hearing aids; service may be performed once every 12 months, per beneficiary
59	Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25.
52	Reduced services: under certain circumstances a service or procedure is partially reduced or eliminated at the discretion of the physician or other qualified health care professional. under these circumstances the service provided can be identified by its usual procedure number and the addition of modifier 52, signifying that the service is reduced. this provides a means of reporting reduced services without disturbing the identification of the basic service. note: for hospital outpatient reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well-being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use).
GA	Waiver of liability statement issued as required by payer policy, individual case
XU	Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service
GW	Service not related to the hospice patient's terminal condition
GY	Item or service statutorily excluded, does not meet the definition of any medicare benefit or, for non-medicare insurers, is not a contract benefit
GZ	Item or service expected to be denied as not reasonable and necessary
Q6	Service furnished under a fee-for-time compensation arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area
XP	Separate practitioner, a service that is distinct because it was performed by a different practitioner
LT	Left side (used to identify procedures performed on the left side of the body)
GX	Notice of liability issued, voluntary under payer policy
RT	Right side (used to identify procedures performed on the right side of the body)
79	Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.)
GC	This service has been performed in part by a resident under the direction of a teaching physician
CR	Catastrophe/disaster related
95	Synchronous telemedicine service rendered via a real-time interactive audio and video telecommunications system: synchronous telemedicine service is defined as a real-time interaction between a physician or other qualified health care professional and a patient who is located at a distant site from the physician or other qualified health care professional. the totality of the communication of information exchanged between the physician or other qualified health care professional and the patient during the course of the synchronous telemedicine service must be of an amount and nature that would be sufficient to meet the key components and/or requirements of the same service when rendered via a face-to-face interaction. modifier 95 may only be appended to the services listed in appendix p. appendix p is the list of cpt codes for services that are typically performed face-to-face, but may be rendered via a real-time (synchronous) interactive audio and video telecommunications system.
HA	Child/adolescent program
UC	Medicaid level of care 12, as defined by each state
X4	Episodic/focused services: for reporting services by clinicians who provide focused care on particular types of treatment limited to a defined period and circumstance; the patient has a problem, acute or chronic, that will be treated with surgery, radiation, or some other type of generally time-limited intervention; reporting clinician service examples include but are not limited to, the orthopedic surgeon performing a knee replacement and seeing the patient through the postoperative period
32	Mandated services: services related to mandated consultation and/or related services (eg, third party payer, governmental, legislative or regulatory requirement) may be identified by adding modifier 32 to the basic procedure.
GV	Attending physician not employed or paid under arrangement by the patient's hospice provider
PO	Excepted service provided at an off-campus, outpatient, provider-based department of a hospital
XE	Separate encounter, a service that is distinct because it occurred during a separate encounter
22	Increased procedural services: when the work required to provide a service is substantially greater than typically required, it may be identified by adding modifier 22 to the usual procedure code. documentation must support the substantial additional work and the reason for the additional work (ie, increased intensity, time, technical difficulty of procedure, severity of patient's condition, physical and mental effort required). note: this modifier should not be appended to an e/m service.
25	Significant, separately identifiable evaluation and management service by the same physician or other qualified health care professional on the same day of the procedure or other service: it may be necessary to indicate that on the day a procedure or service identified by a cpt code was performed, the patient's condition required a significant, separately identifiable e/m service above and beyond the other service provided or beyond the usual preoperative and postoperative care associated with the procedure that was performed. a significant, separately identifiable e/m service is defined or substantiated by documentation that satisfies the relevant criteria for the respective e/m service to be reported (see evaluation and management services guidelines for instructions on determining level of e/m service). the e/m service may be prompted by the symptom or condition for which the procedure and/or service was provided. as such, different diagnoses are not required for reporting of the e/m services on the same date. this circumstance may be reported by adding modifier 25 to the appropriate level of e/m service. note: this modifier is not used to report an e/m service that resulted in a decision to perform surgery. see modifier 57 for significant, separately identifiable non-e/m services, see modifier 59.
27	Multiple outpatient hospital e/m encounters on the same date: for hospital outpatient reporting purposes, utilization of hospital resources related to separate and distinct e/m encounters performed in multiple outpatient hospital settings on the same date may be reported by adding modifier 27 to each appropriate level outpatient and/or emergency department e/m code(s). this modifier provides a means of reporting circumstances involving evaluation and management services provided by physician(s) in more than one (multiple) outpatient hospital setting(s) (eg, hospital emergency department, clinic). note: this modifier is not to be used for physician reporting of multiple e/m services performed by the same physician on the same date. for physician reporting of all outpatient evaluation and management services provided by the same physician on the same date and performed in multiple outpatient setting(s) (eg, hospital emergency department, clinic), see evaluation and management, emergency department, or preventive medicine services codes.
51	Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d).
53	Discontinued procedure: under certain circumstances, the physician or other qualified health care professional may elect to terminate a surgical or diagnostic procedure. due to extenuating circumstances or those that threaten the well being of the patient, it may be necessary to indicate that a surgical or diagnostic procedure was started but discontinued. this circumstance may be reported by adding modifier 53 to the code reported by the individual for the discontinued procedure. note: this modifier is not used to report the elective cancellation of a procedure prior to the patient's anesthesia induction and/or surgical preparation in the operating suite. for outpatient hospital/ambulatory surgery center (asc) reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use).
58	Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78.
76	Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service.
77	Repeat procedure by another physician or other qualified health care professional: it may be necessary to indicate that a basic procedure or service was repeated by another physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 77 to the repeated procedure or service. note: this modifier should not be appended to an e/m service.
99	Multiple modifiers: under certain circumstances 2 or more modifiers may be necessary to completely delineate a service. in such situations modifier 99 should be added to the basic procedure, and other applicable modifiers may be listed as part of the description of the service.
AF	Specialty physician
AQ	Physician providing a service in an unlisted health professional shortage area (hpsa)
CC	Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed)
EP	Service provided as part of medicaid early periodic screening diagnosis and treatment (epsdt) program
GN	Services delivered under an outpatient speech language pathology plan of care
H9	Court-ordered
KX	Requirements specified in the medical policy have been met
PD	Diagnostic or related non diagnostic item or service provided in a wholly owned or operated entity to a patient who is admitted as an inpatient within 3 days
PN	Non-excepted service provided at an off-campus, outpatient, provider-based department of a hospital
Q0	Investigational clinical service provided in a clinical research study that is in an approved clinical research study
Q1	Routine clinical service provided in a clinical research study that is in an approved clinical research study
QJ	Services/items provided to a prisoner or patient in state or local custody, however the state or local government, as applicable, meets the requirements in 42 cfr 411.4 (b)
SA	Nurse practitioner rendering service in collaboration with a physician
X1	Continuous/broad services: for reporting services by clinicians, who provide the principal care for a patient, with no planned endpoint of the relationship; services in this category represent comprehensive care, dealing with the entire scope of patient problems, either directly or in a care coordination role; reporting clinician service examples include, but are not limited to: primary care, and clinicians providing comprehensive care to patients in addition to specialty care
XS	Separate structure, a service that is distinct because it was performed on a separate organ/structure