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Welch Allyn Audiology 2014 REIMBURSEMENT INFORMATION

Welch Allyn Audiology 2014 REIMBURSEMENT INFORMATION
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Welch Allyn Audiology 2014 REIMBURSEMENT INFORMATION - 1

Welch Allyn Audiology 2014 REIMBURSEMENT INFORMATION CPT® CODING RESOURCE FOR AUDIOLOGY & MEDICARE PHYSICIAN FEE SCHEDULE Code Pure tone audiometry (threshold), air only Evoked otoacoustic emissions screening (qualitative measurement of distortion product or transient evoked otoacoustic emissions), automated analysis Evoked otoacoustic emissions screening (qualitative measurement of distortion product or transient evoked otoacoustic emissions), automated analysis—Technical component Evoked otoacoustic emissions screening (qualitative measurement of distortion product or transient evoked otoacoustic emissions), automated analysis—Professional component Distortion product evoked otoacoustic emissions; limited evaluation (to confirm the presence or absence of hearing disorder, 3–6 frequencies) or transient evoked otoacoustic emissions, with interpretation and report Distortion product evoked otoacoustic emissions; limited evaluation (to confirm the presence or absence of hearing disorder, 3–6 frequencies) or transient evoked otoacoustic emissions, with interpretation and report— Technical component Distortion product evoked otoacoustic emissions; limited evaluation (to confirm the presence or absence of hearing disorder, 3–6 frequencies) or transient evoked otoacoustic emissions, with interpretation and report— Professional component The current Physician Fee Schedule does not price this code for Medicare Rates are subject to change. Effective 1/1/2014. For reference only. Information does not constitute a guarantee of coverage or payment. National Average from the 2014 Centers for Medicare and Medicaid Services Physician Fee Schedule. The information contained in this document is provided for convenience only and represents no statement, promise, or guarantee by Welch Allyn concerning coverage or levels of reimbursement. Payment will vary by geographic locality. It is always the provider’s responsibility to determine accurate coding, coverage and claim information for the services that were provided. CPT Copyright 2014 American Medical Association. All rights reserved. CPT is a registered trademark of the American Medical Association. Applicable FARS/ DFARS Restrictions apply to Government Use. Fee Schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability for data contained or not contained herein. Facility—Includes hospitals (inpatient, outpatient, and emergency department), ambulatory surgery centers (ASCs) and skilled nursing facilities (SNFs). Non-Facility—Includes all other settings. TC—Technical Component; for diagnostic tests, the portion of a procedure that does not include a physician’s participation. 26— Professional Component; the portion of diagnostic test that involves a physician’s work and allocation of the practice expense. • outine screening for audiometry testing is not generally covered by Medicare. R • ocumentation in the patient record should indicate the presence of a hearing D problem which required further testing to determine the appropriate medical or surgical treatment. Specific indications for coverage may vary by Medicare Contractor. Providers should refer to their Medicare Contractor’s Local Coverage Determinations for specific coverage and billing guidelines.

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Welch Allyn Audiology 2014 REIMBURSEMENT INFORMATION - 2

PRIVATE PAYERS Private payers typically provide coverage for audiometry testing as part of a standard battery of tests for evaluation of a hearing impairment. Coverage guidelines and payment levels vary by payer and specific plan. Providers should contact each specific plan to determine coverage and payment for the use of Welch Allyn audiology products. MEDICAID Medicaid programs typically provide coverage for audiometry testing as part of a standard battery of tests for evaluation of a hearing impairment. Coverage guidelines and payment levels vary by state. Providers should contact their...

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