Otolaryngology Coding Alert

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Appeal for Bilateral Cochlear Programming

Question: Can I report cochlear implant programming bilaterally?Wisconsin SubscriberAnswer: No, unfortunately, the coding for this service has not caught up with standard practices. You cannot currently report the programming codes 92601-92604 (Diagnostic analysis of cochlear implant ...) bilaterally. On Medicare's fee schedule, the procedures have a bilateral code indicator of "0," which means you can't append modifier 50 (Bilateral procedure).Why: Bilateral cochlear implants are a relatively new development. When the AMA developed and valued codes 92601-92604, no one envisioned performing bilateral cochlear implant surgery or activating both devices in the same visit.Best advice: The best way to address the problem is to appeal to Medicare to remove the status indicator "0" for bilateral payment. The American Academy of Audiology and American Speech-Language-Hearing Association already have petitioned CMS about a change in the status indicator for bilateral payment for programming cochlear implants.Contacts: If you've been rejected for a bilateral claim of [...]
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