Otolaryngology Coding Alert

Question: How should I code the testing done in the following encounter?

A 5-year-old patient is referred by their pediatrician because they failed to pass the hearing screen in the left ear during a pre-kindergarten health assessment. The otolaryngologist had another screening test performed to evaluate the patient’s hearing in both ears (pure tone, air conduction only). The patient’s responses were inadequate, so additional testing was done.

The audiologist’s report for pure tone audiometry (air and bone) and sound booth testing indicates they have sensorineural hearing loss at 50dB in the left ear and normal hearing in the right ear; the patient’s left ear speech threshold is 40dB and right ear speech threshold is 15dB; both within normal limits.

Iowa Subscriber

Answer: You would report 92551 (Screening test, pure tone, air only) for the screening test if it was performed by someone in your office. Check to verify the hearing screen documentation indicates that both ears were tested and make sure you include the results of the screen.

Tip: If the staff does the screening, which is typically the case, the provider should document the results of the screening in their note to show that they actually reviewed the results.

You’d then add 92553 (Pure tone audiometry (threshold); air and bone) to the claim for the test that measures hearing sensitivity and 92555 (Speech audiometry threshold) for the test that measures the minimum hearing level for which the patient can receive or be aware of speech.