ICD 9 Insurance Codes

International Classification of Diseases (ICD-9) Coding

Current Procedural Terminology (CPT)

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

• 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.