Question
We are being told by our billing service that as of March 2003, Medicare no longer reimburses for 92558 or 92559. Have others found this to be true?
Answer
There is no 92558 in the 2003 CPT. I cannot find 92558 in the 1987 CPT. This may have been a local code and HIPAA eliminated the use of any procedure codes other than CPT and HCPCS Level II codes. Medicare only reimburses for diagnostic services (not screening tests) and 92559 is audiometric testing of groups - it would be difficult to argue that this procedure is diagnostic in nature and that a referral would be made for group testing under Medicare. Moreover, the 2003 Medicare Physician Fee Schedule does not list 92559. Steven C. White, PhD Director Health Care Economics and Advocacy American Speech-Language-Hearing Association
Steven C. White, PhD, CCC-A
Director of the Health Care Economics and Advocacy at the ASHA National Office.
Steven C. White, PhD, CCC-A, is the Director of the Health Care Economics and Advocacy at the ASHA National Office. White, an ASHA Fellow, is ex officio to the Health Care Economics Committee. His responsibilities include Medicare, private health insurance and Medicaid especially coding and outpatient reimbursement policies as they relate to these payers. White is the staff liaison to the American Medical Association Current Procedural Terminology Editorial Panel and the AMA Relative Value Update Committee. He has published and presented extensively on third party reimbursement. White is co-author with Janet McCarty of Health Plan Coding and Claims Guide (2005), Negotiating Health Care Contracts and Calculating Fees (2004), Appealing Health Plan Denials, and Getting Your Services Covered. White is also coauthor with Ingrida Lusis and Mark Kander of the Medicare Handbook for Audiologists (2005). White holds a PhD in audiology from Wayne State University and an MS in speech-language pathology and audiology from Ithaca College.
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