Test Your Hearing Test Knowledge With Our Audiologic Function Testing Quiz
Read to the end for a great piece of advice. With CPT® listing so many audiologic function tests, and with each one differing in purpose and methodology, it can be hard to keep them all straight. So, we came up with this quiz to help you differentiate between some of the most common hearing tests your otolaryngology practice may perform. See if you can guess the correct answer to each question. Question 1: What is the difference between 92551 and 92552? On the surface, 92551 (Screening test, pure tone, air only) and 92552 (Pure tone audiometry (threshold); air only) look very similar, and indeed, the tests themselves are similar. In both, the provider plays a series of tones that vary in pitch (and, for 92552, intensity), either through headphones or in a soundproof booth, for a patient who indicates whether they can hear the tones or not. However, the important difference between the tests lies their respective purposes. The test described by 92551 is a screening exam, identifying the presence or absence of a potential hearing problem; whereas 92552 is used as a diagnostic examination, assessing the nature and degree of hearing loss. In other words, the provider will use 92551 when there is no hearing loss diagnosis, while they will use 92552 when the patient has been diagnosed with a hearing loss and the provider is trying to assess its extent. The evaluation involved in 92552 is, therefore, more comprehensive and results in a specific diagnosis; 92551, on the other hand, results in the patient either passing the exam or failing the exam and being referred for additional testing. This explains the difference in the way Medicare values the two tests, with the 2025 national facility and nonfacility valuation for 92551 being $12.29 and 92552 being $38.82. Question 2: How do the pure tone audiometry tests differ? In pure tone audiometry, the difference is not in the purpose of the test but in the tests’ methodologies. Code 92552 describes measurements to determine hearing thresholds by air conduction only, whereas 92553 (Pure tone audiometry (threshold); air and bone) involves administration of both air conduction and bone conduction tests to determine the type of hearing loss. To test the conduction of the patient’s mastoid bone, the provider places a vibrating device on the bone to see if the patient can sense tones as vibrations rather than through the air. The additional testing involved in 92553 results in Medicare valuing the test at $46.90, an increase of $8.08 over 92552. If your office provides automated versions of these tests, however, you’ll use one of the following or the service: You should report these codes when patients utilize a computerized display unit (PC or tablet) to listen to the tones and document their responses. Question 3: What codes do you use for speech audiometry, and how do the services differ? You’ll use 92555 (Speech audiometry threshold) for the test that measures the minimum hearing level for which the patient can receive or be aware of speech, or 92556 (… with speech recognition) when the test also evaluates the patient’s ability to recognize words when played at a certain intensity. Speech audiometry testing is often combined with pure tone air and bone conduction testing for a comprehensive audiological examination. When your provider performs such a service, you’ll assign 92557 (Comprehensive audiometry threshold evaluation and speech recognition (92553 and 92556 combined)). The American Academy of Audiology notes that speech-in-noise testing can also be billed using 92700 (Unlisted otorhinolaryngological service or procedure) “with documentation and explanation of the procedure” with the caveats that your office “should consult payer guidelines for submitting the unlisted code,” and that you should not bill Medicare for the code “if utilized as a predictor of hearing aid performance in noise.” The academy also notes you should never use 92571 (Filtered speech test) for speech-in-noise testing, as this test is used in evaluating central auditory processing. Question 4: What codes do you use for otoacoustic emissions tests, and how do the services differ? Otoacoustic emissions (OAE) tests are used to assess cochlear and/or auditory nervous system function in patients of all ages. The two main codes to document these tests are 92587 (Distortion product evoked otoacoustic emissions; limited evaluation (to confirm the presence or absence of hearing disorder, 3-6 frequencies) or transient evoked otoacoustic emissions, with interpretation and report) and 92588 (… comprehensive diagnostic evaluation (quantitative analysis of outer hair cell function by cochlear mapping, minimum of 12 frequencies), with interpretation and report). The main difference between 92587 and 92588 is the number of frequencies used in the test (three to six in 92587, and 12 or more in 92588). To document either test, you must have an interpretation and report from the provider performing the test. You can only bill these tests if an audiologist or other qualified healthcare provider performs them; just as the pure tone audiology tests have separate codes when the tests are automated, so too does OAE testing. For the automated version of the test, you’ll use 92558 (Evoked otoacoustic emissions, screening (qualitative measurement of distortion product or transient evoked otoacoustic emissions), automated analysis). Again, the differences between all the tests are reflected in their Medicare valuations, with the 2025 national facility and nonfacility valuations for 92587 being $21.03, 92588 being $32.35, and 92558 being $8.09. Final reminder: All audiologic testing codes are inherently bilateral. Per the National Correct Coding Initiative [NCCI] Policy Manual, “only 1 unit of service for any of these CPT® codes may be reported for the described testing on both ears. If only one ear is tested, the appropriate CPT® code should be reported with modifier 52 (Reduced Services).” Bruce Pegg, BA, MA, CPC, CFPC, Managing Editor, AAPC 
