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The CPT® Code 92603 refers to the diagnostic analysis of a cochlear implant for patients aged 7 years or older, which includes the programming of the device. A cochlear implant is a sophisticated electronic device designed to provide a sense of sound to individuals who experience severe bilateral sensorineural hearing loss. This device operates by converting sound waves into electrical signals that stimulate the auditory nerve fibers located in the inner ear, thereby facilitating the perception of sound. The cochlear implant consists of two main components: an internal part that is surgically implanted and an external part that is worn outside the body. Approximately four weeks after the surgical implantation of the internal processor, the external components, which include a microphone, a speech processor, transmitting cables, and a transmitting coil, are connected to the cochlear implant. During this diagnostic analysis, the external components are thoroughly evaluated and programmed to meet the specific auditory needs of the patient. The programming process involves creating a map that establishes the threshold levels of electrical stimulation required for sound perception (T-level) and the maximum level of stimulation that the patient finds comfortable (M or C-levels). This individualized programming is crucial for optimizing the patient's hearing experience. For patients younger than 7 years of age, different codes (92601 and 92602) are utilized, while codes 92603 and 92604 are specifically designated for those aged 7 years and older.
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The diagnostic analysis of a cochlear implant, as represented by CPT® Code 92603, is indicated for patients aged 7 years or older who have been diagnosed with severe bilateral sensorineural hearing loss. This procedure is essential for individuals who require the use of a cochlear implant to restore useful hearing capabilities. The analysis and programming of the cochlear implant are performed to ensure that the device is functioning optimally and tailored to the specific auditory needs of the patient.
The procedure associated with CPT® Code 92603 involves several critical steps to ensure the effective programming of the cochlear implant. First, the external components of the cochlear implant, which include a microphone, a speech processor, transmitting cables, and a transmitting coil, are connected to the internal processor that was implanted surgically. This connection typically occurs approximately four weeks post-surgery. Once connected, a thorough diagnostic analysis is conducted to assess the functionality of the external components. Following this assessment, the programming phase begins. During programming, a map is created for the patient, which involves determining the threshold levels of electrical stimulation necessary for sound perception, known as T-levels. Additionally, the upper limits of electrical stimulation that the patient finds comfortable, referred to as M or C-levels, are established. This mapping process is crucial as it allows for the customization of the cochlear implant to the individual’s hearing capabilities and preferences. After the mapping is completed, the external device is programmed accordingly to ensure that the patient receives the most effective auditory experience possible.
After the diagnostic analysis and programming of the cochlear implant, patients may require follow-up appointments for periodic evaluations and potential reprogramming of the external device. These follow-up sessions are essential to ensure that the cochlear implant continues to meet the auditory needs of the patient as they adapt to the device. Patients are typically monitored for their response to the electrical stimuli and any adjustments needed to enhance their hearing experience. It is important for patients to maintain regular communication with their healthcare provider regarding any changes in their hearing or comfort levels with the device.
| Short Descr | COCHLEAR IMPLT F/UP EXAM 7/> | Medium Descr | ANALYSIS COCHLEAR IMPLT 7 YR/> PRGRMG | Long Descr | Diagnostic analysis of cochlear implant, age 7 years or older; with programming | 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) | 0 - 150% payment adjustment for bilateral procedures 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 | Procedure or Service, Not Discounted when Multiple | Type of Service (TOS) | 1 - Medical Care | Berenson-Eggers TOS (BETOS) | T2D - Other tests - other | MUE | 1 | CCS Clinical Classification | 220 - Ophthalmologic and otologic diagnosis and treatment |
| LT | Left side (used to identify procedures performed on the left side of the body) | 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 | 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.) | RT | Right side (used to identify procedures performed on the right side of the body) | 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). | 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. | 50 | Bilateral procedure: unless otherwise identified in the listings, bilateral procedures that are performed at the same session, should be identified by adding modifier 50 to the appropriate 5 digit code. note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 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. | 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. | 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. | 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. | GA | Waiver of liability statement issued as required by payer policy, individual case | GC | This service has been performed in part by a resident under the direction of a teaching physician | GN | Services delivered under an outpatient speech language pathology plan of care | GV | Attending physician not employed or paid under arrangement by the patient's hospice provider | GW | Service not related to the hospice patient's terminal condition | GX | Notice of liability issued, voluntary under payer policy | 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 | Q1 | Routine clinical service provided in a clinical research study that is in an approved clinical research study | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service |
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| 2013-01-01 | Changed | Short Descriptor changed. |
| 2003-01-01 | Added | First appearance in code book in 2003. |
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