CPT code 92560 is used for Bekesy audiometry screening, a test to evaluate hearing by measuring responses to varying sound frequencies.
CPT code 92560 is used to describe a Bekesy audiometry screen, which is a type of hearing test. This test involves the use of an audiometer that automatically varies the intensity of sound to determine the patient's hearing threshold levels. The Bekesy audiometry screen is typically used to assess the hearing ability of patients by measuring their response to different sound frequencies and intensities, helping healthcare providers diagnose and manage hearing disorders.
For CPT code 92560, which pertains to Bekesy audiometry screening, the following modifiers may be applicable:
1. Modifier 26 - Professional Component: This modifier is used when only the professional component of the service is being billed. It indicates that the provider is billing for the interpretation of the test results, not the technical component.
2. Modifier TC - Technical Component: This modifier is used when only the technical component of the service is being billed. It indicates that the provider is billing for the use of equipment and technical staff, not the interpretation of the results.
3. Modifier 59 - Distinct Procedural Service: This modifier is used to indicate that a procedure or service was distinct or independent from other services performed on the same day. It may be necessary if multiple audiometric tests are performed and need to be billed separately.
4. Modifier 76 - Repeat Procedure by Same Physician: This modifier is used when the same procedure is repeated by the same provider on the same day. It indicates that the test was necessary to be repeated for clinical reasons.
5. Modifier 77 - Repeat Procedure by Another Physician: This modifier is used when the same procedure is repeated by a different provider on the same day. It indicates that the test was necessary to be repeated for clinical reasons by another provider.
6. Modifier 91 - Repeat Clinical Diagnostic Laboratory Test: Although primarily used for laboratory tests, this modifier can be applicable if the audiometry screening needs to be repeated for clinical reasons on the same day.
These modifiers help ensure accurate billing and reimbursement by providing additional context about the service provided. Always verify payer-specific guidelines as they may have unique requirements for modifier usage.
CPT code 92560, which pertains to Bekesy audiometry screen, is not reimbursed by Medicare. According to the Medicare Physician Fee Schedule (MPFS), this specific code is not assigned a reimbursement value, indicating that it is not covered under standard Medicare Part B services.
Additionally, Medicare Administrative Contractors (MACs), which are responsible for processing claims and determining coverage specifics in their respective jurisdictions, typically follow the guidelines set forth by the MPFS. Therefore, healthcare providers should be aware that claims submitted for CPT code 92560 are likely to be denied by Medicare, and alternative coding or justification may be necessary for reimbursement.
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