Summary & Overview
CPT 92653: Auditory Evoked Response for Neurologic Evaluation
CPT code 92653 represents an auditory evoked response test used to measure a patient’s physiologic response to sound stimuli for evaluation of neurological disorders; the service includes interpretation and a report. This code is clinically important for diagnosing conditions that affect auditory pathways or brainstem function and supports clinical decision-making in neurology, otology, and related specialties. Nationally, use of this diagnostic modality impacts specialty care pathways, device programming, and neurologic diagnostic workflows.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical purpose of the code, typical sites of service, and the payer landscape relevant to coverage and billing. The publication summarizes common billing modifiers associated with the service, highlights where this procedure fits within diagnostic service lines, and identifies related clinical contexts for which the test is commonly ordered.
This piece provides benchmarks and policy-relevant context to help billing managers, compliance staff, and clinicians understand coding expectations, documentation elements tied to interpretation and reporting, and typical utilization settings. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 92653 describes a diagnostic procedure in which the provider measures a patient’s response to sound stimuli to evaluate for a neurological disorder. The service explicitly includes the interpretation and a written report by the performing clinician.
Service type: Diagnostic neuro-audiologic testing
Typical site of service: Hospital outpatient department, outpatient clinic, or specialized neurodiagnostic laboratory
Clinical & Coding Specifications
Clinical Context
A 58-year-old patient is referred to a neurophysiology laboratory for evaluation of suspected auditory neuropathy after progressive, asymmetric sensorineural hearing loss and intermittent tinnitus. The referring neurologist requests objective measurement of the auditory pathway to differentiate cochlear from retrocochlear causes. The patient arrives for scheduled testing, registration and consent are completed, and the technologist reviews history for contraindications (e.g., active ear infections). The test environment is quiet and electrically shielded. Surface electrodes are placed, and calibrated sound stimuli are delivered via earphones while the electrophysiologist records auditory brainstem responses. The interpreting provider reviews waveform morphology, latencies, and interpeak intervals, documents findings in an interpretation and prepares a formal report for the referring clinician. The encounter may occur in an outpatient hospital-based clinic, freestanding neurodiagnostic center, or an ambulatory surgical center when diagnostic workup for a neurological disorder is required.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when billing only the physician interpretation/report separate from technical recording. |
TC |