Summary & Overview
CPT 92623: Auditory Osseointegrated Sound Processor Programming and Verification
CPT code 92623 is an add‑on procedural code for additional time spent on diagnostic analysis, programming, and verification of auditory osseointegrated (bone‑anchored) sound processors. It captures each additional 15 minutes of professional work beyond the initial 60 minutes required to program and verify these implanted or externally coupled devices. Accurate use of this code matters nationally as bone‑anchored hearing solutions expand and as payers refine coverage and payment for device programming services.
This analysis covers major national payers including Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise explanation of the clinical service the code represents, typical sites of service, and which payers commonly adjudicate claims for this type of device programming. The publication summarizes billing considerations, common modifier usage (listed elsewhere), and the policy context that influences reimbursement for add‑on timed services. It also provides national benchmarking information where available and highlights common administrative and documentation elements required to support time‑based billing for iterative device programming.
Intended for clinicians, billing professionals, and policy analysts, the piece clarifies the clinical context for 92623, outlines payer coverage patterns, and points to the operational details necessary to code and document additional timed programming sessions for auditory osseointegrated sound processors.
Billing Code Overview
CPT code 92623 describes diagnostic analysis, programming, and verification of an auditory osseointegrated sound processor — a bone‑anchored device that converts sound energy to be received by the inner ear. This code represents each additional 15 minutes of professional time after the initial 60 minutes spent on device programming and verification.
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Service type: Device programming, diagnostic analysis, and verification for auditory osseointegrated (bone‑anchored) sound processors
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Typical site of service: Audiology clinic, otology/neurotology clinic, or other outpatient specialty settings where device fitting and programming occur
Clinical & Coding Specifications
Clinical Context
A 45-year-old adult with conductive hearing loss previously implanted with an osseointegrated bone-anchored hearing system presents for postoperative device programming and verification. The patient is seen in an outpatient audiology or otolaryngology clinic after the surgical placement of the abutment and sound processor or after receiving an upgraded processor. The clinical workflow includes review of the surgical history and device model, objective device checks, behavioral audiometric testing, device fitting and programming using manufacturer software, real-ear or aided sound-field verification, patient counseling on device use and hygiene, and documentation of total professional time. The initial 60 minutes of device programming and verification is reported with the primary code for the session; additional continuous 15-minute increments of extra time are reported with 92623 as an add-on when the service extends beyond the first 60 minutes. Typical sites of service are outpatient hospital clinics, ambulatory surgery centers for immediate post-op programming visits, and freestanding audiology or otolaryngology offices. Typical patient scenarios include initial post-implant activation, complex reprogramming for atypical anatomy or mixed hearing components, upgrade programming after device replacement, or prolonged verification when troubleshooting poor aided performance.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component |