CPT code 92650 is used for auditory evoked potentials screening, a test to measure the brain's response to sound stimuli.
CPT code 92650 is used to describe the procedure for screening auditory evoked potentials, which are tests that measure the electrical activity in the brain in response to sound stimuli. This code is typically utilized by audiologists or other healthcare professionals to assess the auditory pathways from the ear to the brainstem. The procedure is non-invasive and helps in diagnosing hearing loss or neurological disorders related to auditory processing.
For CPT code 92650, which pertains to auditory evoked potentials for screening purposes, there are several modifiers that could be applicable depending on the specific circumstances of the service provided. Here is a list of potential modifiers and the reasons for their use:
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 supplies necessary to perform the test, excluding the professional 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 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 provider on the same day. It indicates that the procedure was necessary to be repeated for valid 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 procedure was necessary to be repeated for valid 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 auditory screening is repeated on the same day for the same patient to obtain subsequent results.
These modifiers help ensure accurate billing and reimbursement by providing additional context about the services rendered. It's important for healthcare providers to use these modifiers appropriately to avoid claim denials and ensure compliance with payer policies.
CPT code 92650, which refers to a specific service, is subject to reimbursement considerations under Medicare. To determine if this code is reimbursed by Medicare, healthcare providers should consult 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.
Additionally, reimbursement for CPT code 92650 may vary depending on the region, as Medicare Administrative Contractors (MACs) have the authority to make local coverage determinations. MACs are responsible for processing Medicare claims and can provide guidance on whether this specific code is covered in their jurisdiction. Therefore, it is crucial for healthcare providers to verify with their respective MAC to ensure accurate billing and reimbursement for CPT code 92650.
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