Summary & Overview
CPT 92553: Pure Tone Audiometry, Air and Bone Conduction
CPT code 92553 denotes pure tone audiometry with both air and bone conduction testing to identify the softest audible tones and to characterize the type and degree of hearing loss. This diagnostic procedure is a foundational tool in audiology and otolaryngology for evaluating sensorineural versus conductive hearing deficits and for guiding clinical management, hearing aid candidacy, and further diagnostic workup. Nationally, consistent reporting of 92553 is important for access to diagnostic hearing services and for quality measurement in hearing healthcare.
Key payers addressed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical context for CPT code 92553, typical sites of service, and the types of benchmarks and policy considerations commonly associated with diagnostic audiology services. The publication outlines reimbursement benchmarks, common billing modifiers and their use cases, and implications for coding accuracy and documentation. It also highlights common payer coverage patterns and documentation expectations relevant to audiologists and otolaryngologists. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 92553 describes pure tone audiometry testing with both air and bone conduction. The provider presents a series of tones at varying intensities to identify the softest level at which the patient can hear and to determine the type and amount of hearing loss. The service includes placing a vibrating device over the mastoid bone for bone conduction testing in addition to air conduction thresholds.
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Service type: Diagnostic audiologic testing (pure tone audiometry with air and bone conduction)
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Typical site of service: Audiology clinic, ENT (otolaryngology) office, outpatient clinic, or other ambulatory care setting where diagnostic hearing assessment is performed.
Data not available in the input for associated taxonomies, ICD-10 diagnoses, related codes, and service line.
Clinical & Coding Specifications
Clinical Context
A 62-year-old patient presents to an outpatient audiology clinic with progressive difficulty hearing conversational speech and trouble hearing on the telephone over the past year. The provider reviews the history, performs otoscopic inspection to exclude cerumen impaction and middle ear effusion, and documents reported asymmetric hearing and tinnitus. The patient is escorted to a sound-treated audiometric booth. The audiologist instructs the patient and performs air-conduction pure tone testing using calibrated headphones to determine the softest intensity level at which the patient can detect tones across frequencies (pure tone audiometry). The provider also places a bone oscillator over the mastoid to perform bone-conduction testing to differentiate sensorineural from conductive components. Results are recorded as air and bone thresholds and used to compute air-bone gaps, degree, and configuration of hearing loss. Typical workflow includes pretest counseling, otoscopy, pure tone air- and bone-conduction testing (92553), speech reception threshold and word recognition testing as indicated, and documentation of findings in the medical record. Typical sites of service are outpatient audiology clinics, ENT (otolaryngology) offices, or hospital outpatient departments. The service type is diagnostic audiometry with pure tone air and bone-conduction thresholds to assess presence, type, and degree of hearing loss.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 |