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Answer: Pediatricians are going to be asking this question more and more as pressure mounts to conduct early screening for hearing problems. The applicable codes pay well, if you have the appropriate equipment.
If you do speech testing without an audiometer, simply by whispering, for example, there is no specific code. This kind of test is included in the E/M service. Likewise, if you use a tuning fork, it is included in the E/M code. The audiometry CPT codes clearly require calibrated electronic equipment.
If you use a select picture audiometer, a common office-based hearing screen, you should code 92583 (Select picture audiometry).
Many primary care pediatricians perform pure tone screening. In this case, you should report 92551 (Screening test, pure tone, air only). For testing a child's ability to hear soft sounds (threshold testing), use code 92552 (Pure tone audiometry [threshold]; air only). This is the "bell-tone" hearing test.
Usually, only audiologists conduct sophisticated speech detection testing. The codes are 92555 (Speech audiometry threshold) and 92556 ( with speech recognition). These procedures usually are done only on children 3 years of age or older.
The most sophisticated tests are otoacoustic emissions tests (a screen) and auditory evoked potential tests (a diagnostic test). For an infant, use 92587 (Evoked otoacoustic emissions; limited [single stimulus level, either transient or distortion products]) as a screening test. This test is done on all babies in some states by law. If the screen reveals a possible problem, the next test usually not performed in the office is an auditory evoked potential test. You should use 92585 (Auditory evoked potentials for evoked response audiometry and/or testing of the central nervous system; comprehensive). Most likely, you will send the patient to a neurologist first.
Finally, audiologists (but not primary care pediatricians) frequently perform complete evaluations on children who seem to have hearing problems, reporting codes 92557 (Comprehensive audiometry threshold evaluation and speech recognition [92553 and 92556 combined]), 92553 (Pure tone audiometry [threshold]; air and bone) or 92556 (Speech audiometry threshold; with speech recognition).
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