CPT code 92653 is used for auditory evoked potentials, neurodiagnostic testing, interpretation, and report, aiding in hearing and neurological assessments.
CPT code 92653 is used to describe the neurodiagnostic evaluation of auditory evoked potentials (AEPs) for both interpretation and report. This code is typically utilized by audiologists or neurologists to assess the electrical activity in the brain in response to sound stimuli. The procedure involves recording the brain's responses to auditory signals, which can help in diagnosing hearing loss, neurological disorders, or other auditory pathway issues. The results are then interpreted and documented in a detailed report, which is essential for guiding further treatment or management plans.
For CPT code 92653, which pertains to auditory evoked potentials for neurodiagnostic purposes, the following modifiers may be applicable:
1. Modifier 26 - Professional Component: This modifier is used when the service provided is the professional component only, such as the interpretation of the test results, without the technical component.
2. Modifier TC - Technical Component: This modifier is used when the service provided is the technical component only, 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 a procedure or service was distinct or independent from other services performed on the same day. It may be necessary if multiple procedures are performed that are not typically reported together.
4. Modifier 76 - Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional: This modifier is used when the same procedure is repeated by the same provider on the same day.
5. Modifier 77 - Repeat Procedure by Another Physician or Other Qualified Health Care Professional: This modifier is used when the same procedure is repeated by a different provider on the same day.
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 test results.
Each of these modifiers serves a specific purpose and should be used according to the specific circumstances of the service provided. Proper use of modifiers ensures accurate billing and reimbursement.
CPT code 92653, which pertains to a specific procedure, is subject to reimbursement considerations under Medicare. To determine if this code is reimbursed by Medicare, healthcare providers should refer to the Medicare Physician Fee Schedule (MPFS). The MPFS provides a comprehensive list of services covered by Medicare and their respective reimbursement rates.
Additionally, Medicare Administrative Contractors (MACs) play a crucial role in interpreting and implementing Medicare policies, including reimbursement decisions for specific CPT codes like 92653. Providers should consult their local MAC for guidance on whether CPT code 92653 is reimbursed in their jurisdiction, as coverage can vary based on regional policies and specific circumstances.
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. For instance, with RevFind, you can identify discrepancies related to CPT code 92653, ensuring you receive the full reimbursement you deserve. Schedule a demo today to see how RevFind can optimize your revenue recovery process.
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