Otolaryngology Coding Alert

When a patient receives a cochlear implant, an audiologist must initially program the speech-generating device and then periodically adjust it.

Background: Analysis and programming of a cochlear implant is not included in 69930 (Cochlear device implantation, with or without mastoidectomy), and you can report the service separately, even during 69930s 90-day global period. The audiologist usually performs the initial programming a month or so after the implant. Then he makes follow-up adjustments as many as a dozen times or more in the first year, followed by only four adjustments in subsequent years, depending on the patient.

Who can do it? In a clarification dated Oct. 1, 2008, CMS made it clear that only audiologists,physicians, and non-physician practitioners may report 92601-92604. These services may not be provided by speech-language pathologists or others, the clarification said.

Diagnosis: Check to be sure you have the proper diagnosis code for bilateral hearing loss caused by damage to the sensory cells and/or nerve fibers of the inner ear. For instance, Empire Blue Cross Blue Shield lists two codes:

" 389.11 -- Sensory hearing loss, bilateral

" 389.18 -- Sensorineural hearing loss, bilateral.