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Otolaryngology Coding Alert

Adhere to Audiometry Edits You Won't Find in CCI

Audiologists use VRA, CPA for patients who can't participate in threshold tests

Once you have the -411- on what visual reinforcement audiometry (VRA) and conditioning play audiometry (CPA) are, nonpublished threshold bundles will make more sense to you, resulting in faster coding. Discover the Subjects of 7 Audio Tests You-re probably in the habit of looking to the Correct Coding Initiative (CCI) as your guide to properly reporting code combinations. But when it comes to reporting seven audiometry codes, you need to understand what the tests are to understand why certain combinations are mutually exclusive -- quot;  and why you should never bill them together. Get the scoop on these tests:

Pure tone audiometry: This threshold test uses pure tone to indicate a patient's range of hearing. Classify this test to 92552 (Pure tone audiometry [threshold]; air only) or 92553 (- air and bone).

Speech: Speech audiometry tests (92555, Speech audiometry threshold; and 92556 ... with speech recognition) use spoken words and sentences rather than pure tones.

Comprehensive: When the audiologist performs both pure tone tests and speech recognition, code the comprehensive audiometry threshold with 92557 (Comprehensive audiometry threshold evaluation and speech recognition [92553 and 92556 combined]).

CPA: In conditioning play audiometry, the child learns to perform a certain task (for example, place a block in a box) when she hears a certain sound. CPA requires a conditioned response. -We usually perform this test on children from 2-1/2 to 3 years old to about 5 years old,- says Gerard A. McCall, MA, CCC-A & SP, audiologist at Eastern ENT Sinus and Allergy Center PA in Goldsboro, N.C. Report CPA with 92582 (Conditioning play audiometry).

VRA: Audiologists typically provide visual reinforcement audiometry (VRA) for young children, usually those with an age -between 4 months and 36 months,- McCall says. The child indicates a -positive- response -by repeatable orienting responses,- he says.

During the test, the child wears earphones or sits between speakers. When the patient hears a tone, he turns toward the source with a head turn or eye rotation. You should code VRA with 92579 (Visual reinforcement audiometry [VRA]). Edit 1: Realize CPA/VRA Replaces 92557 Although no published edit bundles comprehensive audiometric testing (92557) with conditioning play audiometry (92582), you shouldn't report this combination. Why? -CPA and VRA are substitutes for 92557,- says Mark Kander, director of healthcare regulatory analysis at the American Speech-Language-Hearing Association in Rockville, Md.

When a patient cannot participate in a threshold exam, he may instead undergo CPA or VRA. -We use VRA for children below age 2-1/2 to 3 years old and find it to be efficient and reliable, though not as reliable as threshold,-  McCall says. Edit 2: Opt for Either 92552 or 92579 You also shouldn't report VRA with audio [...]