CODING AND REIMBURSEMENT | Specialty Series: Tinnitus

By Richard S. Tyler, Anna Marie Jilla, and Susan Von Dollen

This article is a part of the March/April 2020, Volume 32, Number 2, Audiology Today issue. The National Health Interview Survey found that approximately 10 percent of U.S. adults had experienced tinnitus in the 12 months previous to the survey (Bhatt et al, 2016; Shargorodsky et al, 2010). This article reviews codes useful when providing tinnitus services. For clinical guidance, the interested reader is directed to the American Academy of Otolaryngology Head and Neck Surgery Clinical Practice Guideline for Tinnitus (Tunkel et al, 2014). Although tinnitus services and devices are billed to a variety of payers, this article focuses on guidance for filing claims for Medicare beneficiaries and appropriate coding based on procedures chosen at the discretion of the clinician.

Evaluation and Associated Current Procedural Terminology (CPT) Codes

The following diagnostic procedures are commonly used by audiologists in audiologic assessments for patients with tinnitus.

All codes presented in this section assume binaural procedures; if only one ear is tested, usage of the -52 Reduced Services modifier is recommended. As a reminder, under the description for 92557—Comprehensive audiometry, threshold evaluation, and speech recognition—all four components (air- and bone-conduction pure-tone testing, speech-recognition threshold, and suprathreshold word discrimination) should be completed. For more specific coding information for acoustic reflex threshold measurement (included in 92550: Tympanometry and acoustic reflex threshold measurements and 92570: Acoustic immittance testing) and appropriate use of 92587: Distortion product otoacoustic emissions, limited evaluation and 92588: Distortion product otoacoustic emissions, comprehensive diagnostic evaluation, the reader is directed to the Coding and Reimbursement section of the Academy’s website, www.audiology.org (American Academy of Audiology, 2019).