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Otolaryngology Coding Alert

Reader Question:
Avoid Straight Code for 1-Sided Tinnitus Testing

Question: A patient received tinnitus assessment on only one ear. What is the proper way to report the testing? Florida Subscriber Answer: You should code a monaural tinnitus assessment with 92625 (Assessment of tinnitus [includes pitch, loudness matching, and masking]) and append modifier 52 (Reduced services). -For unilateral assessment, use modifier 52,- directs the parenthetical instruction following 92625 in the CPT manual. Why: Code 92625 represents bilateral testing, according to the AMA's CPT Changes 2005: An Insider's View. So you must indicate a reduction in services, via modifier 52, if the audiologist tests only one ear. -- You Be the Coder and Reader Questions answered/reviewed by Barbara J. Cobuzzi, MBA, CPC, CPC-H, CPC-P, CHCC, director of outreach programs for the American Academy of Professional Coders based in Salt Lake City.


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