CPT code 92589 is used for auditory function tests, helping healthcare providers categorize and track services for efficient reimbursement.
CPT code 92589 is used to describe auditory function tests, which are procedures performed to evaluate a patient's hearing capabilities. These tests are typically conducted by audiologists or other hearing specialists to assess how well a person can hear various sounds, tones, and pitches. The results of these tests help in diagnosing hearing impairments and determining the appropriate treatment or intervention needed to address any identified hearing issues.
For CPT code 92589, which pertains to auditory function test(s), 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 used when a service or procedure is partially reduced or eliminated at the physician's discretion. It indicates that the service 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 a laboratory test is repeated on the same day to obtain subsequent (multiple) test results.
Each modifier should be used in accordance with the specific guidelines and documentation requirements to ensure accurate billing and reimbursement.
CPT code 92589, which pertains to auditory function test(s), 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. The MPFS outlines the payment policies and rates for services covered under Medicare Part B, including those related to auditory function tests.
However, it's important to note that the final decision on reimbursement can also depend on the local coverage determinations made by the Medicare Administrative Contractor (MAC) in your region. MACs are responsible for processing Medicare claims and have the authority to establish specific coverage criteria and guidelines that may affect whether CPT code 92589 is reimbursed. Therefore, healthcare providers should consult both the MPFS and their respective MAC's policies to ascertain the reimbursement status and any specific requirements or documentation needed for CPT code 92589.
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. With RevFind, you can identify discrepancies for specific services, such as CPT code 92589, ensuring you receive the full reimbursement you deserve. Schedule a demo today to see how RevFind can streamline your revenue processes and maximize your financial performance.
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