CPT code 92652 is used for auditory evoked potential threshold estimation at multiple frequencies, including interpretation and report.
CPT code 92652 is used for auditory evoked potentials (AEP) threshold estimation at multiple frequencies, both ipsilateral and contralateral. This code is typically utilized by audiologists or other healthcare professionals to document the procedure of measuring the auditory system's response to sound stimuli at various frequencies. The test helps in assessing hearing thresholds and is crucial for diagnosing hearing impairments or disorders. The "ipsilateral" and "contralateral" terms refer to testing on the same side and opposite side of the body, respectively, which provides comprehensive data on auditory function.
For CPT code 92652, which involves auditory evoked potential threshold estimation at multiple frequencies, the following modifiers may be applicable:
1. Modifier 22 - Increased Procedural Services: This modifier is used when the work required to provide a service is substantially greater than typically required. If the auditory evoked potential testing is more complex or time-consuming than usual, this modifier may be appropriate.
2. Modifier 52 - Reduced Services: If the procedure is partially reduced or eliminated at the physician's discretion, this modifier can be applied. For instance, if fewer frequencies are tested than originally planned, Modifier 52 might be used.
3. Modifier 76 - Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional: This modifier is applicable if the procedure needs to be repeated on the same day by the same provider. It indicates that the repeated service was necessary.
4. Modifier 77 - Repeat Procedure by Another Physician or Other Qualified Health Care Professional: Similar to Modifier 76, but used when the repeat procedure is performed by a different provider.
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 may be necessary if multiple distinct auditory tests are performed.
6. Modifier 91 - Repeat Clinical Diagnostic Laboratory Test: If the auditory evoked potential test needs to be repeated for clinical reasons, this modifier can be used to indicate that the repeat test was necessary.
These modifiers help provide additional information about the circumstances under which the procedure was performed, ensuring accurate billing and reimbursement. Always ensure that the use of modifiers is supported by proper documentation in the patient's medical record.
CPT code 92652 is subject to reimbursement by Medicare, but its coverage and payment are determined by several factors, including the Medicare Physician Fee Schedule (MPFS) and the policies set forth by the Medicare Administrative Contractor (MAC) in your specific region.
The MPFS provides a comprehensive list of fees that Medicare uses to reimburse physicians and other healthcare providers for services rendered. However, the final determination of whether CPT code 92652 is reimbursed can vary based on local coverage determinations (LCDs) and national coverage determinations (NCDs) established by the MAC.
Therefore, it is crucial for healthcare providers to consult the specific MAC guidelines and the MPFS to confirm the reimbursement status and any potential requirements or limitations associated with CPT code 92652.
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