This guide aims to provide coding, billing, and coverage guidance for audiologic evaluation and management of tinnitus. Additional guidance will be provided for hyperacusis and misophonia, as available.
Clinicians are strongly encouraged to reference payer-specific policies when determining appropriate code reporting and documentation requirements for testing. Further, Medicare local coverage determinations and other payer policies will address which ICD codes support medical necessity and subsequent reimbursement for services. It is advisable to review payer guidelines and policies prior to billing.
Relevant Procedure Codes
The following Level I HCPCS CPT codes are available for reporting diagnostic assessment of tinnitus. There are currently no CPT codes that encompass assessment and management for hyperacusis and misophonia.
| CPT Code | Description | ||
| 92625 | Assessment of tinnitus (includes, pitch, loudness matching, and masking) | ||
| 92700 | Unlisted otorhinolaryngologic service or procedure *May be appropriate to report for hyperacusis and misophonia audiometric and inventory assessments. Do not report multiple units of 92700 on the same date of service. Additional documentation for reporting 92700 is required. Learn More |
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| Note: Other audiometric procedures that may be included as part of a tinnitus assessment (e.g., otoacoustic emissions, pure tone audiometry, tympanometry, etc.) are discussed elsewhere in coding guidance by topic. Learn More | |||
Relevant Diagnosis Codes
The following ICD codes are available for reporting tinnitus diagnoses. A more complete list of ICD codes relevant to audiologic practice are presented here.
| ICD-10 Diagnosis Codes | Description |
| H93.11 Tinnitus (right ear) H93.12 Tinnitus (left ear) H93.13 Tinnitus (bilateral) H93.19 Tinnitus (unspecified ear) |
A perceived sound in the absence of an external sound that can be described as a ringing, clicking, whooshing, crickets, radio static, etc., and can be subjective or objective in nature. |
| H93.A1 Pulsatile tinnitus (right ear) H93.A2 Pulsatile tinnitus (left ear) H93.A3 Pulsatile tinnitus (bilateral) H93.A9 Pulsatile tinnitus (unspecified ear) |
A perceived sound that coincides with the heartbeat |
| H93.231 Hyperacusis (right ear) H93.232 Hyperacusis (left ear) H93.233 Hyperacusis (bilateral) H93.239 Hyperacusis (unspecified ear) |
An abnormally disproportionate increase in the sensation of loudness in response to auditory stimuli of normal volume. |
| H93.291 Other abnormal auditory perceptions (right ear) H93.292 Other abnormal auditory perceptions (left ear) H93.293 Other abnormal auditory perceptions (bilateral) H93.299 Other abnormal auditory perceptions (unspecified ear) |
Other abnormal auditory perceptions not otherwise outlined in other ICD codes (e.g., auditory recruitment, diplacusis, hyperacusis, temporary auditory threshold shift, central auditory processing disorder, etc.). |
Medicare Coverage Policies for Audiologic Assessment and Treatment of Tinnitus
Medicare provides coverage for tinnitus assessment and evaluation but does not cover audiological treatment or management options for tinnitus. This includes hearing aids, sound therapy devices, tinnitus maskers, programmatic tinnitus treatments, or tinnitus-related audiologic counseling. These non-covered services should not be billed to Medicare. If claims need to be submitted for denial (e.g., for coordination with a secondary insurance plan) or if the patient requests that the claim be submitted to Medicare, the -GY modifier (Item or service statutorily excluded, does not meet the definition of any Medicare benefit) must be used with any codes for these non-covered services and/or devices. Additional information on Medicare coverage policies for audiologic procedures can be found here.
Frequently Asked Questions
- How do I report 92625 (Assessment of Tinnitus) if testing was only performed on one ear?
- How do I report tinnitus, hyperacusis, and misophonia assessment and management procedures which do not have a CPT code?
- Are there any codes available to report for tinnitus, misophonia, and/or hyperacusis supplies, items, or related durable medical equipment?
- What is the difference between ICD diagnosis codes for Tinnitus (H93.11-H93.19) and Other Abnormal Auditory Perceptions (H93.291-H93.299)?
- When is it appropriate to report Auditory Hallucinations (R44.0)?
Need more help?
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Disclaimer
The purpose of the information provided by the American Academy of Audiology Coding and Reimbursement Committee is strictly for educational guidance to audiologists. Action taken with respect to the information provided is an individual choice. The American Academy of Audiology hereby disclaims any responsibility for the consequences of any action(s) taken by any individual(s) as a result of using the information provided, and reader agrees not to take action against, or seek to hold, or hold liable, the American Academy of Audiology for the reader's use of the information provided. As used herein, the "American Academy of Audiology" shall be defined to include its directors, officers, employees, volunteers, members, and agents.
