Summary & Overview
CPT 92562: Alternating Binaural Pure-Tone Audiometry
CPT code 92562 describes an alternating binaural pure-tone hearing test used to evaluate a patient’s type of hearing loss by delivering tones alternately to each ear. Nationally, this code is a standard component of audiologic assessment for patients with suspected asymmetric hearing loss, tinnitus, or auditory processing complaints and factors into clinical workflows, coverage decisions, and claims reporting across payers. Key payers included in the analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise clinical context for the procedure, payer coverage considerations, and an overview of typical service settings. The publication reviews common billing and coding themes associated with this audiometric test, presents coverage patterns and utilization benchmarks where available, and highlights relevant policy clarifications that affect claim adjudication. It also outlines how the service integrates with audiology and otolaryngology care pathways and what providers and billing staff typically need to document to support medical necessity. Data not provided in the input is noted as unavailable.
Billing Code Overview
CPT code 92562 describes a hearing test in which the provider delivers tones alternately between both ears to evaluate the type of hearing loss. This procedure is an audiometric assessment used to determine unilateral or bilateral hearing differences and to help distinguish between conductive and sensorineural hearing loss.
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Service type: Pure-tone audiometry presented alternately to each ear
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Typical site of service: Audiology clinic, otolaryngology (ENT) office, hospital outpatient audiology department, or hearing center
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Clinical & Coding Specifications
Clinical Context
A 56-year-old patient presents to an outpatient audiology clinic with progressive difficulty understanding speech and intermittent ringing in both ears. The patient reports worse hearing in background noise over the past year and a history of noise exposure from occupational machinery. The clinician (a licensed audiologist or otolaryngologist) performs an air-conduction pure tone audiometry test delivering tones alternately between both ears to determine hearing thresholds and characterize the type (conductive, sensorineural, or mixed) and degree of hearing loss. The typical workflow includes patient history and otoscopic inspection, patient positioning in a sound-treated booth, earphone placement, calibration verification, presentation of pure tones to each ear via air conduction, threshold determination across standard frequencies (250–8000 Hz), and documentation of results in the medical record. Results guide further management such as diagnostic tympanometry, speech audiometry, referral to otolaryngology, hearing aid evaluation, or vestibular testing as clinically indicated. Typical site of service is an outpatient audiology clinic or otolaryngology office with access to a calibrated audiometer and sound-treated booth. The service type is diagnostic audiological testing (pure tone air-conduction threshold testing with alternate ear presentation).
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when only the interpretation/reading portion is billed separate from technical components |