The Academy of Doctors of Audiology (ADA), the American Academy of Audiology (AAA), and the American Speech-Language-Hearing Association (ASHA) developed the following frequently asked questions as a resource to assist members with practice and billing questions for the otoacoustic emissions (OAE) screening code, Current Procedural Terminology (CPT) code 92558, as well as the new code descriptors for CPT codes 92587 and 92588. It is recommended that members consult with their facility billing department as well as with third-party payers for guidance. Payers may dictate the use of specific diagnosis codes, modifiers, and coverage determinations. Members should also consider consulting with equipment distributors if questions arise regarding specific equipment protocols and capabilities.
The descriptors for the OAE codes are as follows:
92558: Evoked otoacoustic emissions, screening (qualitative measurement of distortion product or transient evoked otoacoustic emissions), automated analysis
92587: Distortion product evoked otoacoustic emissions, limited evaluation (to confirm the presence or absence of hearing disorder, 3–6 frequencies) or transient evoked otoacoustic emissions, with interpretation and report
92588: Distortion product evoked otoacoustic emissions, comprehensive diagnostic evaluation (quantitative analysis of outer hair cell function by cochlear mapping, minimum of 12 frequencies), with interpretation and report
For CPT code 92588, the code descriptor says a "minimum of 12 frequencies." Does that mean I need to perform 12 frequencies in total or 12 frequencies per ear?
A minimum of 12 frequencies would need to be completed for each ear.
Who can perform CPT code 92558, the OAE screening code?
Support personnel, an audiologist, or a physician can perform this test.
If the provider of the service relies only on the equipment determining the pass/fail response, without further clinical assessment and/or interpretation, use 92558.
What is required with "interpretation and report"?
You are to include the interpretation of the test results in the patient's medical record. A printout from the equipment by itself is not considered a report.
Do I need a modifier with any of these codes?
CPT code 92558 may require the -33 modifier (preventive service). It is important that audiologists consult the specific guidance that will be provided by some third-party payers which may dictate the use of this modifier.
What is the difference between 92587 and the screening code?
The screening code (92558) is an automated pass/fail test, which may be performed by support personnel. CPT code 92587 requires 3–6 distinct frequencies, interpretation, and a statement of the presence or absence of hearing loss and the frequencies affected.
For CPT codes 92587 and 92588, can a technician perform the test and an audiologist do the interpretation and report?
Yes, as with all the codes that have the technical component (TC)/professional component (PC) split (92540-92546, 92548, and 92585), if the test is performed by a technician under the direct supervision of a physician or by a physician, the test can be filed with the -TC modifier. If an audiologist is performing the interpretation and report, they would file the claim with the -26 modifier (professional component). Under Medicare, services provided by a technician cannot be filed by an audiologist or with the audiologist's National Provider Identifier (NPI). Members should consult other third-party payers for specific guidance regarding audiologist supervision of technicians.
What if my equipment does not have the capability to perform 12 distinct frequencies?
Anything less than 12 frequencies will require reporting code 92587, with interpretation.
What if I do both distortion product and transient evoked OAEs?
You may report code 92587 with the -22 modifier (increased procedural service) to indicate the additional test.
Do the frequencies have to be octave and midoctave?
No, they can be any combination indicated by case history or test results, but the requirement of at least 12 distinct frequencies for each ear must be met in order to file 92588.
I repeat six frequencies two times per ear for reliability. Can this be considered as the minimum of 12 frequencies for CPT code 92588?
While it is important to prove reliability, this scenario does not constitute the minimum of 12 frequencies for the utilization of CPT code 92588, since it is six frequencies that have been repeated. Code 92588 requires 12 discrete frequencies. You may, of course, run 12 frequencies twice for reliability, which would constitute appropriate use of 92588.
CPT codes are the property of the American Medical Association. This guidance is for informational purposes only and was created by the Academy of Doctors of Audiology, the American Academy of Audiology, and the American Speech-Language-Hearing Association.