CPT code 92583 is used for select picture audiometry, a test that evaluates hearing ability by having patients identify pictures.
CPT code 92583 is used to describe the procedure of select picture audiometry. This is a type of hearing test primarily used for children or individuals who may have difficulty with traditional audiometry methods. During this test, the patient is asked to identify pictures or objects in response to auditory stimuli, which helps in assessing their hearing ability. This method is particularly useful in evaluating the hearing of young children who are not yet able to verbally communicate their responses or follow complex instructions.
For CPT code 92583, "Select picture audiometry," the following modifiers may be applicable depending on the specific circumstances of the service provided:
1. Modifier 22 - Increased Procedural Services: This modifier is used when the work required to provide a service is substantially greater than typically required. Documentation must support the substantial additional work and the reason for it.
2. Modifier 52 - Reduced Services: This modifier is applicable when a service or procedure is partially reduced or eliminated at the physician's discretion. It indicates that the service provided was less than usually required.
3. Modifier 76 - Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional: This modifier is used when a procedure or service is repeated by the same provider subsequent to the original procedure or service.
4. Modifier 77 - Repeat Procedure by Another Physician or Other Qualified Health Care Professional: This modifier is used when a procedure or service is repeated by a different provider subsequent to the original procedure or service.
5. 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 is used to identify procedures/services that are not normally reported together but are appropriate under the circumstances.
6. Modifier 91 - Repeat Clinical Diagnostic Laboratory Test: This modifier is used when it is necessary to repeat the same laboratory test on the same day to obtain subsequent (multiple) test results.
These modifiers should be used in accordance with the specific guidelines and payer policies to ensure accurate billing and reimbursement. Proper documentation is essential to support the use of any modifier.
CPT code 92583, which pertains to select picture audiometry, is subject to reimbursement by Medicare, but this is contingent upon several factors. The Medicare Physician Fee Schedule (MPFS) is a critical resource that determines whether a specific CPT code is reimbursable and at what rate. To ascertain if CPT code 92583 is covered, healthcare providers should consult the MPFS for the current year, as reimbursement rates and coverage can change annually.
Additionally, Medicare Administrative Contractors (MACs) play a significant role in the reimbursement process. MACs are responsible for processing Medicare claims and have the authority to make local coverage determinations (LCDs) that can affect whether a particular service is reimbursed in their jurisdiction. Therefore, it is essential for healthcare providers to verify with their specific MAC to ensure that CPT code 92583 is covered under their local policies and to understand any documentation or medical necessity requirements that may apply.
In summary, while CPT code 92583 can be reimbursed by Medicare, providers must review the MPFS and consult with their MAC to confirm coverage and compliance with any local guidelines.
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 92583. Schedule a demo today to see how our solution can help you maximize your reimbursements and ensure you’re getting paid what you deserve.
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
