Otolaryngology Coding Alert

Question:

When can we bill an audio technician's service for Medicare?

Washington, D.C. Subscriber

Answer:

You may use audio techs when there is no professional thought process: only codes that have PC (Professional component) or TC (Technical component) associated with them. Remember, a technician can only perform the TC under direct supervision of the physician.

For instance, in 92540-92548 (Vestibular Function Tests, With Recording [e.g., ENG]), the audio tech can do the TC part (meaning the doctor, NPP or audiologist does the PC). Most payers consider these tests' TC to not requiring a doctor's, NPP's or audiologist's skill.

Other services in which an audio tech can perform the technical part include:

92585 -- Auditory evoked potentials for evoked response audiometry and/or testing of the central nervous system; comprehensive;

92587 -- Evoked otoacoustic emissions; limited (single stimulus level, either transient or distortion products);

92588 -- Evoked otoacoustic emissions; comprehensive or diagnostic evaluation (comparison of transient and/or distortion product otoacoustic emissions at multiple levels and frequencies);

92567 -- Tympanometry (impedance testing). Per CMS Transmittal 84, an audio tech can perform this service since most tympanometers will perform the test automatically, once a seal is established. A seal is when no air leaks out of the ear canal so that the eardrum can be moved with air pressure changes. If you have no seal, you have no eardrum movement.

Warning: CPT indicates no TC in 92557 (Comprehensive audiometry threshold evaluation and speech recognition [92553 and 92556 combined]) so an audio tech cannot provide this service.

When a qualified technician performs the technical component of the TC-PC split codes, make sure the otolaryngologist documents the PC service. This includes "clinical decision- making and other active participation in the delivery of the service," according to CMS Transmittal 84. Medicare contractors may request the credentials of the technician. (For a copy of the newest transmittal 2044, where CMS doesn't mention 92567, you may email Claire Gamboa at cgamboa@codinginstitute.com).