Otolaryngology Coding Alert

Question: I have a certified audiologist in my office who performs all hearing tests including auditory brainstem response (ABR) and electronystagmography (ENG) tests. Medicare representatives and physicians at various billing courses told me that I must be present in the office to bill for these services. The June 2005 Otolaryngology Coding Alert reader question "Column 'Z' Reveals Supervision Requirements," however, points out that these services require only a level-five Medicare physician supervision. How do I clarify this matter with Medicare?Alabama SubscriberAnswer: Otolaryngologists and coding experts often make the mistake of confusing incident-to rules with diagnostic testing supervision rules. But "because the diagnostic tests benefit set forth in 1861(s)(3) of the Act is separate and distinct from the incidentto benefit set forth in 1861(s)(2) of the Act, diagnostic tests need not meet the incident-to requirements," states Medicare Part B Reference Manual (from HGSAdministrators www.hgsa.com/professionals/refman/appendix-l-m.html).When discussing audiologic function tests (92552-92557, 92561-92585, [...]