Otolaryngology Coding Alert

Question: A mother presents with her 3-year-old son. She is worried that the child can't hear her because he doesn't acknowledge her when she speaks to him. After testing the boy, the audiologist determines that his hearing is actually very good. Which diagnosis should I use? Should I report a V72 code?

New Jersey Subscriber

Answer: Although you may use V72.1 (Examination of ears and hearing), many payers do not pay for procedures that contain a V code as the primary diagnosis. Therefore, since no ICD-9 code exists for describing not finding a hearing problem during testing, a better choice is 388.40 (Other abnormal auditory perception; abnormal auditory perception, unspecified). Using 388.40 explains the reason for performing the test, such as 92552 (Pure tone audiometry [threshold]; air only). However, you may use the V code as a secondary diagnosis.

- Answers to You Be the Coder and Reader Questions provided by Lori Bogan, administrator at ENT Associates of East Texas in Tyler; Barbara Cobuzzi, MBA, CPC, CPC-H, an otolaryngology coding and reimbursement specialist and president of Cash Flow Solutions, a medical billing firm in Lakewood, N.J.; Roger Hettinger, CPC, CMC, coding specialist at Sioux Valley Clinic in Sioux Falls, S.D.; and Darlene Reed, CPC, certified coder at Northland Ear, Nose and Throat in Liberty, Mo.