Summary & Overview
CPT 92582: Pediatric Behavioral Audiometry for Young Children
CPT code 92582 designates a pediatric behavioral audiometry assessment used to measure the type and severity of hearing loss in young children, typically ages two to four, through analysis of behavioral responses to sound stimuli. This evaluation is a key tool in early identification of hearing impairment, which has nationwide implications for language development, educational planning, and appropriate referral for intervention services.
Key payers included in the coverage discussion are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of clinical context and typical care settings, summary benchmarks where available, and relevant policy and coverage considerations affecting payment and prior authorization for pediatric audiologic testing. The publication outlines the typical service line and common modifiers used with this code when available, and it highlights areas where payers commonly differ in coverage policies or documentation requirements.
The content is intended for clinicians, billing staff, and policy analysts seeking a succinct national-level briefing on clinical use, billing classification, and payer considerations for CPT code 92582.
Billing Code Overview
CPT code 92582 describes an audiologic behavioral assessment of hearing for a young child, generally two to four years of age, who does not have developmental or physical impairment. The provider measures the type and severity of hearing loss by analyzing the patient’s behavioral responses to specific sound stimuli.
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Service type: Pediatric behavioral audiometry
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Typical site of service: Outpatient audiology clinic or pediatric otolaryngology practice
Clinical & Coding Specifications
Clinical Context
A 3-year-old child is brought by a parent to an outpatient pediatric audiology clinic due to concerns that the child does not consistently respond to verbal requests and may have delayed speech. The child has no known developmental or physical impairments. A pediatric audiologist performs behavioral audiometry appropriate for young children — measuring the type and severity of hearing loss by presenting age-appropriate sound stimuli (speech, tones, or toy-based sounds) and observing conditioned responses. The workflow includes brief history and otoscopy by the audiologist or pediatrician, explanation of the test to the caregiver, age-appropriate conditioning (visual reinforcement or play audiometry), stimulus presentation to each ear, documentation of threshold responses, interpretation of results, and preparation of an audiology report. If results are abnormal, the audiologist communicates findings to the referring pediatrician and family and may recommend diagnostic audiologic follow-up, medical evaluation, or early intervention services.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when only the professional component (interpretation/reporting) is billed separately from the technical component. |
TC |