Coding for ABR

Question

Answer

The CPT codes to use for infant hearing screening are: 92586 Auditory evoked potentials, limited, or 92587 Evoked acoustic emission, limited.

PART II
I am an employee of an ENT who recently went to a ''coding'' course and was told that audiologists should not be using the ''global'' code of 92585 for billing ABRs. It was stated that audiologists are not allowed to bill for the professional component of this code (only the technical component) and should therefore be billing it with the TC modifier. I have always done the testing and the interpretation and received reimbursement for both, from Medicare, by using the 92585 code.

Audiologists in independent practice can only bill Medicare for the technical component (TC) of ABRs. However, if the audiologist is in a physician's office, global billing is appropriate when the physician is involved with the patient's care. This billing differentiation is due to the structure of the Medicare physician fee schedule where only physicians (as defined in the Medicare statute) can be reimbursed for the work RVU.

Steven C. White, Ph.D.
Director
Health Care Economics and Advocacy
American Speech-Language-Hearing Association
phone 301-897-0126
fax 301-897-7356