Otolaryngology Coding Alert
Refer to Column 'Z' for Supervision Requirements
Question: Vermont Subscriber Answer: You can find a code's supervision requirements in column "Z" of the National Physician Fee Schedule Relative Value File. If the "Physician Supervision of Diagnostic Procedures" column contains a "5," the audiologist may perform the test off-site, and you can still bill the service. "Physician supervision policy does not apply when the procedure is personally furnished by a qualified audiologist; otherwise the procedure must be performed under the general supervision of the physician," states Medicare Transmittal B-01-28. Examples of the audiologic function tests that an offsite audiologist may perform and bill under her personal identification number (that is, you are not billing incidentto the physician) include: • 92552-92556 -- Audiometry tests • 92557 -- Comprehensive audiometry threshold ... • 92561 -- Bekesy audiometry; diagnostic • 92562-92584 -- Various balance, hearing and audiometry tests • 92585-TC -- Auditory evoked potentials ... comprehensive; Technical component • 92587-TC-92588-TC -- Evoked otoacoustic emissions ... Technical component. Example: A Medicare beneficiary presents with a complaint of hearing loss. After an otolaryngologist takes a history and exam, she orders audiometric testing. An offsite, otolaryngologist-employed audiologist completes the testing and diagnoses sensorineural hearing loss. Because Medicare assigns level-five supervision to 92557 (Comprehensive audiometry threshold evaluation and speech recognition [92553 and 92556 combined]), you should report the audiologist's service using her PIN. The physician does not have to be present in the exam room (personal) or office suite (direct) or provide overall direction and control (general) for the audiologist to perform the comprehensive audiometry evaluation. Link 92557 to the audiologist's findings, sensorineural hearing loss (389.1x). File form 855R to assign the benefits to the otolaryngologist. Don't forget:
Otolaryngology Coding Alert
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