ICD 9 Insurance Codes

 

International Classification of Diseases (ICD-9) Coding

380.01 Acute otitis media, unspecified
380.1 Otitis externa
381.1 Chronic serous OM
381.2 Chronic mucoid OM
381.81 Dysfunction of Eustachian Tube
382.01 Acute OM with spont. rupture of the ear drum
384.2 Perforation of the TM, unspec.
385 Tympanosclerosis, involving the TM only
385.23 Discontinuity of the Ossicles
385.32 Cholesteatoma of the ME
388.31 Tinnitus, subjective
388.42 Hyperacusis
388.43 Impaired Aud. Discrim.
388.6 Otorrhea, unspec.
388.7 Otalgia, unspec.
389 Conductive Hearing Loss Unspec.
389.01 Conductive Hearing Loss External ear
389.02 Conductive Hearing Loss Tympanic Mem.
389.03 Conductive Hearing Loss Middle ear
389.1 Sensorineural Hearing Loss Unspec.
389.11 Sensorineural Hearing Loss Sensory
389.12 Sensorineural Hearing Loss Neural
389.14 Sensorineural Hearing Loss Central
389.18 Sensorineural Hearing Loss Combined types
389.2 Mixed: Cond. and SNHL
744 Unspecified anomaly of the ear with impairment of hearing
744.01 Absence of external ear
744.02 Anomalies of external ear with impairment of hearing Atresia or stenosis
744.23 Microtia
794.15 Abnormal Auditory Function Studies
V72.1 exam of ears and hearing
XXXXX There is no code for “normal hearing”

 

 

Current Procedural Terminology (CPT)

92510 Aural rehabilitation following cochlear implant (includes evaluation of aural rehabilitation status and hearing, therapeutic services) with or without speech processor programming
92551 Screening test, pure tone, air only
92552 Pure tone audiometry (threshold); air only
92553 Pure tone audiometry (threshold); air and bone
92555 Speech audiometry threshold
92556 Speech audiometry threshold; with speech recognition
92557 Comprehensive audiometry threshold evaluation and speech recognition (92553 and 92556 combined)
92567 Tympanometry
92579 Visual reinforcement audiometry (VRA)
92582 Conditioning play audiometry
92583 Select picture audiometry
92585 Auditory evoked potentials for evoked response audiometry and/or testing of the central nervous system; comprehensive
92586 Auditory evoked potentials for evoked response audiometry and/or testing of the central nervous system; limited
92587 Evoked otoacoustic emissions; limited (single stimulus level, either transient or distortion products)
92590 Hearing aid examination and selection; monaural
92591 Hearing aid examination and selection; binaural
92592 Hearing aid check; monaural
92593 Hearing aid check; binaural
92594 Electroacoustic evaluation for hearing aid; monaural
92596 Ear mold, binaural
92620 Evaluation of central auditory function, with report; initial 60 minutes
92621 Evaluation of central auditory function, with report; each additional 15 minutes
92630 Auditory rehabilitation; pre-lingual hearing loss
92700 Unlisted otorhinolaryngological service or procedure
99002 Handling, conveyance, and/or any other service in connection with the implementation of an order involving devices (eg, designing, fitting, packaging, handling, delivery or mailing) when devices such as orthotics, protectives, prosthetics are fabricated by an outside laboratory or shop but which items have been designed, and are to be fitted and adjusted by the attending physician
99499 Unlisted evaluation and management service

 

Modifier Descriptors

-26 Professional Component

Certain procedures are a combination of a professional component and a technical component. When the professional component is reported separately, add the modifier -26 to the usual procedure code. The professional provides the cognitive or professional component (e.g., interpretation) of an auditory brainstem response: 92585-26

-TC Technical Component

When the technical component is reported separately, add the modifier -TC to the procedure code. The technical component is billed using 92585-TC. Reporting 92585, without the -26 or -TC modifiers, implies the entire service was provided by the billing entity.

-52 Reduced Services

Under certain circumstances, a service or procedure is partially reduced or eliminated at the provider’s discretion. Add the modifier -52, signifying that the service is reduced. This provides a means of reporting reduced services without disturbing the identification of the basic service. The audiologist performs pure tone air and bone conduction testing on one ear: 92553-52

-53 Discontinued Service

Under certain circumstances a procedure is stopped due to extenuating circumstances or those that threaten the patient’s well being. Use of this modifier indicates that the procedure was started but discontinued. A patient becomes ill during an ABR and is unable to continue: 92585-53

From DoD Infant and Birth Registry

Newborn Early Hearing Detection and Intervention

Encounter Type ICD-9-CM Diagnosis Codes CPTE & M Codes CPT Procedure Codes
Newborn Hearing Screening with no abnormalities(Inpatient SIDR) V72.1 N/A N/A
Newborn Hearing Screening with abnormalitiesperformed in Newborn Nursery or Neonatal ICU (Inpatient SIDR) V72.1 and 794.15* or 389.xx** N/A N/A
Newborn Hearing Screening with no abnormalitiesperformed in Newborn Nursery or Neonatal ICU (Inpatient rounds SADR) V72.1 99499 or 992xx* 92586 or 92587
Newborn Hearing Screening with no abnormalitiesperformed in Audiology Clinic *** (Outpatient visit SADR) V72.1 99499 or 992xx* 92586 or 92587
Follow-up with no abnormalities 794.15 99499 92585 and 92588
Follow-up with a bnormalities 389.xx* 99499 92585 and 92588
Intervention 1 389.xx* 99499 92590,92591,92700
Intervention 2 389.xx* 99499 92590,92591,99002
1 st Follow-up to intervention 389.xx* 99499 92590,92591,92594 or 92595
  • Code to be used by non-professionals (e.g. technicians, nurse, volunteers).
  • ** Indicates there are various 4 th and/or 5 th digits that my be assigned to indicate a specific condition or encounter
  • *** Initial screening exam for patients who were not tested in the hospital prior to discharge from birth episode.

 

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