CPT code 92587 is used for a limited evoked auditory test, which assesses hearing by measuring responses to sound stimuli.
CPT code 92587 is used to describe a limited evoked auditory test. This procedure involves measuring the auditory system's response to sound stimuli, typically to assess hearing function. The "limited" designation indicates that the test is focused on a specific aspect or is less comprehensive than a full auditory evaluation. This code is often used in clinical settings to help diagnose hearing impairments or to monitor auditory health, particularly in patients who may be at risk for hearing loss.
For CPT code 92587, which pertains to evoked auditory test limited, the following modifiers may be applicable:
1. Modifier 26 - Professional Component: This modifier is used when the service provided is the professional component of the test, such as the interpretation of the results, rather than the technical component.
2. Modifier TC - Technical Component: This modifier is used when the service provided is the technical component of the test, such as the use of equipment and technician time, without the professional interpretation.
3. Modifier 59 - Distinct Procedural Service: This modifier is used to indicate that the procedure is distinct or independent from other services performed on the same day. It may be necessary if multiple auditory 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 physician on the same day. It indicates that the repeat procedure was necessary and not a duplicate billing.
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 helps differentiate between services provided by different healthcare providers.
6. Modifier 91 - Repeat Clinical Diagnostic Laboratory Test: This modifier is used when a clinical diagnostic test is repeated for the same patient on the same day to obtain subsequent results. It is applicable if the auditory test needs to be repeated for clinical reasons.
These modifiers help ensure accurate billing and reimbursement by providing additional context about the services rendered. It is important to use them appropriately to avoid claim denials or delays.
CPT code 92587, which refers to an evoked auditory test limited, is subject to reimbursement by Medicare, but this is contingent upon several factors. The Medicare Physician Fee Schedule (MPFS) provides a comprehensive list of services covered by Medicare, including their respective reimbursement rates. To determine if CPT code 92587 is reimbursed, healthcare providers should consult the MPFS to verify its inclusion and the associated payment amount.
Additionally, Medicare Administrative Contractors (MACs) play a crucial role in the reimbursement process. MACs are responsible for processing Medicare claims and have the authority to establish local coverage determinations (LCDs) that may affect the reimbursement of specific CPT codes. Therefore, it is essential for healthcare providers to review any relevant LCDs issued by their regional MAC to ensure compliance with coverage criteria and documentation requirements for CPT code 92587.
In summary, while CPT code 92587 can be reimbursed by Medicare, providers must verify its status on the MPFS and adhere to any guidelines or restrictions set forth by their MAC to ensure successful reimbursement.
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