CPT® Code 92577

Official Description

Stenger test, speech

Common Language Description

The Stenger test, classified under CPT® Code 92577, is a specialized auditory assessment designed to evaluate hearing capabilities using spondee words. Spondee words are defined as two-syllable words that are pronounced with equal emphasis on each syllable, such as "airplane," "padlock," and "baseball." This test is conducted using earphones, allowing for a controlled environment where each ear can be tested both separately and simultaneously. The primary objective of the Stenger test is to determine the hearing threshold for each ear by delivering a spondee word at the patient's individual hearing threshold. During the procedure, the patient is instructed to repeat the word and indicate whether it was heard in the right or left ear. In individuals with normal hearing or functional hearing loss, the expected outcome is that a word presented to the right ear at the hearing threshold will be perceived in the right ear, while a word presented to the left ear will be heard in the left ear. When words are delivered simultaneously to both ears at the same hearing threshold, the sound is typically perceived centrally in the head, provided that the sensitivity levels of both ears are equal. However, if there is a discrepancy in sensitivity levels, the sound will be perceived in the ear with the higher sensitivity until the intensity in the less sensitive ear is adjusted to match its hearing threshold. In cases where nonorganic hearing loss is suspected—whether psychogenic or feigned—the Stenger test results will deviate from the expected pattern, indicating a lack of genuine auditory perception. This test is often integrated with other hearing assessments, and patients are generally unaware that the Stenger test is being conducted, as it serves to differentiate between functional and nonorganic hearing loss. The results of the test are documented on an audiogram, and a written interpretation of the findings is provided to ensure clarity and facilitate further evaluation or treatment as necessary.

1. Indications

The Stenger test is indicated for the assessment of hearing capabilities in patients where there is a suspicion of nonorganic hearing loss. This includes situations where the following conditions may be present:

Functional Hearing Loss The test is utilized to differentiate between true hearing loss and cases where the patient may be exaggerating or feigning hearing impairment.
Psychogenic Hearing Loss The Stenger test helps identify patients who may have hearing loss stemming from psychological factors rather than physiological issues.
Assessment of Auditory Perception It is indicated for evaluating the auditory perception of patients who may present with inconsistent hearing test results.

2. Procedure

The Stenger test procedure involves several key steps to accurately assess the patient's hearing thresholds. First, the patient is fitted with earphones to ensure that sound delivery is controlled and isolated to each ear. The audiologist begins by determining the hearing threshold for each ear separately. This is accomplished by presenting spondee words at varying intensity levels until the patient can accurately repeat the words. Once the individual thresholds are established, a spondee word is delivered to each ear at the determined hearing threshold. The patient is then asked to indicate which ear they heard the word in, either the right or the left. In a typical scenario with normal hearing, the patient will correctly identify the ear corresponding to the presented word. Following this, the audiologist presents the same spondee word simultaneously to both ears at the established hearing threshold. If the sensitivity levels of both ears are equal, the patient will perceive the sound centrally in their head. However, if there is a difference in sensitivity, the sound will be perceived in the ear with the higher sensitivity level until the intensity in the less sensitive ear is increased to match its threshold. Throughout the test, the audiologist carefully observes the patient's responses and records the results on an audiogram. This documentation is crucial for interpreting the findings accurately. The Stenger test is often conducted in conjunction with other hearing assessments to provide a comprehensive evaluation of the patient's auditory capabilities.

3. Post-Procedure

After the Stenger test is completed, the audiologist will analyze the results obtained from the audiogram. A written interpretation of the findings is provided to summarize the outcomes of the test. This interpretation is essential for determining the presence of functional or nonorganic hearing loss. Depending on the results, further evaluation or intervention may be recommended. Patients may be advised on the next steps, which could include additional testing, counseling, or referral to other specialists if necessary. It is important for the audiologist to communicate the results clearly to the patient and any relevant healthcare providers to ensure appropriate follow-up care.

Short Descr	STENGER TEST SPEECH
Medium Descr	STENGER TEST SPEECH
Long Descr	Stenger test, speech
Status Code	Active Code
Global Days	XXX - Global Concept Does Not Apply
PC/TC Indicator (26, TC)	3 - Technical Component Only Code
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
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
KX	Requirements specified in the medical policy have been met
XS	Separate structure, a service that is distinct because it was performed on a separate organ/structure