Internal Medicine Coding Alert

Break 92552-92557 into sound, word, and combo tests

It's easy to drift off course when navigating threshold exam coding " unless you follow these expert tips.

1. Choose the Right Category
 
 Look at the sound the service involves. CPT divides the five threshold test codes into three categories:
 • pure tone: If the test uses pure tone, consider 92552 (Pure tone audiometry [threshold]; air only) and 92553 (... air and bone).
 • speech: Speech audiometry (92555, Speech audiometry threshold; and 92556 ... with speech recognition) "tests utilize spoken words and sentences rather than pure tones," states Empire Medicare Services in its local coverage determination "Audiologic/
Vestibular Function Tests."
 • comprehensive: When the provider performs both pure tone tests and speech recognition, code the comprehensive audiometry threshold with 92557 (Comprehensive audiometry threshold evaluation and speech recognition [92553 and 92556 combined]).
 
2. Look at Conduction to Pick a Pure Tone Code
 
 You should choose the correct pure tone threshold
code based on the conduction method that the internist uses. If he uses earphones to present sound by air conduction, report 92552, according to Empire Medicare Services (downstate New York excluding Queens).
 When the test also involves a skull vibrator to present sounds by bone conduction, you should instead assign 92553.

3. Use Word, Decibel When Assigning Speech Code

 If the test instead involves words, you should look at the next two audiology codes in the series. "In speech threshold (92555), the patient must identify two-part words, such as hot dog and baseball at certain decibel levels," says Debbie Abel, AuD, audiologist at Northern Arizona Speech and Hearing Center in Sedona, Ariz., and owner of Alliance Audiology in Alliance, Ohio. Use 92556 for a test that involves a list of one-part words with no decibel variation.

4. Roll 92553 and 92556 Into 92557

 Watch out: If your internist performs both 92553 and 92556 during the same visit, you should report 92557 (Comprehensive audiometry threshold evaluation and speech recognition [92553 and 92556 combined]).
 This comprehensive evaluation forms the cornerstone of diagnostic testing for presbycusis diagnosis. In addition, audiometry (92557) may reveal a high-frequency sensorineural hearing loss.