What is the CPT code for a hearing test?
This is a common question, but there isn't a single CPT code for "a hearing test." Instead, there is a range of codes that describe specific audiological procedures. The correct code depends entirely on the type and complexity of the test performed by the audiologist.
For example, a basic pure-tone hearing test has a different code than a comprehensive evaluation that also includes speech recognition and middle ear testing. This system allows for precise billing that reflects the exact services a patient receives. This guide will help you explore the most common codes and understand the system used for medical billing in audiology.
Quick Answer: The most common code for a comprehensive hearing evaluation for both ears is CPT code 92557. However, many other codes exist for different, specific tests.
What is a CPT code and why is it used?
CPT stands for Current Procedural Terminology. It is a comprehensive set of medical codes maintained by the American Medical Association (AMA) that healthcare providers use to report medical, surgical, and diagnostic procedures and services to insurance companies for reimbursement.
Standardization
CPT codes provide a uniform language for describing medical services, ensuring that a "pure-tone audiometry" test is reported the same way in California as it is in New York. This consistency is crucial for processing claims efficiently and accurately.
Billing & Reimbursement
The primary purpose of CPT codes is for billing. When a provider submits a claim to an insurer, the CPT code tells the insurer exactly what service was performed so they can determine the appropriate reimbursement amount.
Data & Analytics
CPT codes are also used for tracking medical procedures, measuring performance, and conducting research. Public health officials can analyze CPT data to understand trends in healthcare services across the country.
Common Hearing Test Codes
Explore some of the most frequently used CPT codes in audiology. Click on a test to reveal its associated code and learn more about what it entails. These codes describe the procedure performed.
What's the difference between CPT and ICD-10 codes?
It's a common point of confusion, but CPT and ICD-10 codes serve two distinct and complementary purposes. A medical claim almost always includes both types of codes. Think of it as telling a story: the ICD-10 code explains "why" a patient was seen, and the CPT code explains "what" the doctor did.
⚕️ CPT Codes
The "What" - Procedure
CPT codes describe the specific medical service or procedure performed by the healthcare provider. They answer the question, "What did the doctor do?"
- Example: 92557 (Comprehensive audiometry)
- Stands For: Current Procedural Terminology
- Managed By: American Medical Association (AMA)
🩺 ICD-10 Codes
The "Why" - Diagnosis
ICD-10 codes are used to document a patient's diagnosis or condition. They answer the question, "Why did the patient need this service?"
- Example: H90.3 (Sensorineural hearing loss, bilateral)
- Stands For: International Classification of Diseases, 10th Revision
- Managed By: World Health Organization (WHO)
How do I find the correct CPT code?
Finding the correct CPT code is critical for proper billing and reimbursement. While this guide provides an overview of common codes, it is not a substitute for official resources or professional guidance. The process requires careful attention to detail and adherence to official guidelines.
1. Consult the Official CPT Codebook
The American Medical Association (AMA) publishes the official CPT codebook annually. This is the definitive source for all codes, guidelines, and modifiers. Healthcare providers and billing professionals should always use the current year's edition.
2. Match the Service to the Code Description
Carefully read the full description of a CPT code to ensure it accurately reflects the service that was provided. Many codes have subtle but important distinctions. For example, some codes specify if a test was for one ear (monaural) or both (binaural).
3. Use Professional Billing Software & Resources
Most electronic health record (EHR) and medical billing software systems have built-in CPT code lookups. Additionally, professional organizations like the American Academy of Audiology (AAA) provide coding resources and guidance for their members.
Important Disclaimer: This web application is for informational purposes only and should not be used as a substitute for professional medical billing advice or the official CPT code set. Always consult with a qualified professional or the official AMA CPT resources for billing decisions.