Summary & Overview
CPT 92570: Tympanometry with Reflex Threshold and Reflex Decay Testing
CPT code 92570 represents a bundled audiologic evaluation that includes tympanometry, acoustic reflex threshold measurement, and acoustic reflex decay testing when all three tests are completed by a provider. These combined tests assess middle-ear compliance and neural reflex pathways, aiding in identification of the anatomical site contributing to hearing loss. Nationally, the code is relevant to outpatient audiology and otolaryngology practices, hearing centers, and Medicare-covered diagnostic services.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise clinical context for the bundled testing performed under 92570, typical sites of service, and the practical implications for billing and claim submission. The publication provides benchmark-oriented coverage considerations, common modifier interactions (listed separately), and connections to related audiologic services.
This summary structures information for clinicians, billing staff, and policy analysts who need a clear national overview of what CPT code 92570 represents, how it is used in practice, and what coverage stakeholders commonly include in analyses of audiology diagnostic codes. Data not available in the input is noted where applicable in detailed sections.
Billing Code Overview
CPT code 92570 is a global audiologic test panel that bundles tympanometry, acoustic reflex threshold measurement, and acoustic reflex decay testing when all three procedures are performed together. The grouped services evaluate the functional integrity of the tympanic membrane and middle ear and help localize conductive versus sensorineural causes of hearing loss.
Service type: Diagnostic audiology tests (middle-ear and reflex assessment)
Typical site of service: Audiology clinic, otolaryngology clinic, or outpatient hearing center
Clinical & Coding Specifications
Clinical Context
A 45-year-old patient presents to an otolaryngology or audiology clinic with complaints of unilateral hearing loss, ear fullness, and intermittent tinnitus following a recent upper respiratory infection. The audiologist or otolaryngologist performs a targeted middle-ear assessment that includes tympanometry, acoustic reflex threshold measurement, and acoustic reflex decay testing billed together under 92570. The workflow begins with a brief history and otoscopic exam to exclude cerumen impaction or perforation. Tympanometry is performed to evaluate middle-ear compliance and pressure. Acoustic reflex thresholds are obtained to assess stapedius muscle response and auditory brainstem integrity; reflex decay testing evaluates neural adaptation suggestive of retrocochlear pathology. Results are reviewed with the patient, documented in the medical record, and used to guide further testing (pure tone audiometry, speech audiometry, otoacoustic emissions, or imaging) or management (medical therapy, referral to neurology, or ENT surgical consultation). Typical sites of service include outpatient audiology clinics, otolaryngology offices, and ambulatory surgical centers that provide diagnostic audiologic testing.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when reporting only the physician or audiologist professional interpretation/reading separate from technical service |