CPT code 92567 is used for tympanometry, a test that evaluates the function of the middle ear by measuring eardrum movement.
CPT code 92567 is used to describe the procedure of tympanometry. Tympanometry is a diagnostic test that evaluates the condition of the middle ear and the mobility of the eardrum (tympanic membrane) and the conduction bones by creating variations of air pressure in the ear canal. This test is commonly used to detect issues such as fluid in the middle ear, ear infections, or eustachian tube dysfunction. It is a valuable tool for healthcare providers to assess and diagnose ear-related conditions, ensuring appropriate treatment plans are developed for patients experiencing hearing or balance issues.
For CPT code 92567, which pertains to tympanometry, the following modifiers may be applicable depending on the specific circumstances of the service provided:
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 the technician's time, excluding the interpretation.
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 procedures are performed that are not typically reported together.
4. Modifier 76 - Repeat Procedure by Same Physician: This modifier is used when the same procedure is repeated by the same physician on the same day. It indicates that the procedure was necessary to be repeated for the patient's care.
5. Modifier 77 - Repeat Procedure by Another Physician: This modifier is used when the same procedure is repeated by a different physician on the same day. It indicates that the procedure was necessary to be repeated for the patient's care by another provider.
6. Modifier 91 - Repeat Clinical Diagnostic Laboratory Test: Although less common for tympanometry, this modifier is used when a laboratory test is repeated on the same day to obtain subsequent results. It may apply if tympanometry is performed multiple times for diagnostic purposes.
These modifiers should be used appropriately to ensure accurate billing and reimbursement, reflecting the specific circumstances under which the tympanometry service was provided. Always verify payer-specific guidelines as they may have unique requirements for modifier usage.
CPT code 92567 is reimbursed by Medicare, as it is included in the Medicare Physician Fee Schedule (MPFS). The MPFS is a comprehensive listing of fees used by Medicare to reimburse physicians and other healthcare providers for services rendered.
However, the reimbursement for CPT code 92567 can vary based on geographic location and other factors, as determined by the local Medicare Administrative Contractor (MAC). MACs are responsible for processing Medicare claims and have the authority to make decisions on coverage and reimbursement within their jurisdiction.
Therefore, it is essential for healthcare providers to verify the specific reimbursement rates and coverage policies for CPT code 92567 with their respective MAC.
Discover how MD Clarity's RevFind software can enhance your revenue cycle management by accurately reading your contracts and detecting underpayments down to the CPT code level and by individual payer. For instance, with RevFind, you can identify discrepancies related to CPT code 92567. Schedule a demo today to see how our solution can help you recover lost revenue and ensure accurate payments.
Get paid in full by bringing clarity to your revenue cycle
Subscribe to the
Healthcare Clarified newsletter
Get the latest insights on RCM and healthcare policy in your inbox
