Question
What CPT code should be used when billing for a Tullio procedure?
Answer
If you do no other procedure except for a test for Tullio's and you do so by presenting a loud sound, then 92700 would be the appropriate CPT code to use. That code would need to be accompanied by a report stating why you did this particular evaluation, how you did it, what equipment was used, how long it took, what you found, what benefit it was to the patient, and your recommendations. Having said that, if you perform a test for Tullio's as part of a comprehensive battery, you would have the choice of 92700 or billing no other additional code apart from 92557. This would be on the basis that you presented loud sounds to the ear(s) whether they be pure tones, narrow bands of noise, or speech. And if you test for Tullio's using air pressure as part of a tympanogram, I would offer the guidance not to report anything in addition to 92567. The amount of effort that would go into the report elements for a 92700, to distinguish it from a tympanogram, is probably not worth the reimbursement you would receive or the aggravation of a payment denial because it was, in reality part and parcel to a tympanogram.
Robert C. Fifer, Ph.D. is currently the Director of Audiology and Speech-Language Pathology at the Mailman Center for Child Development, Department of Pediatrics, University of Miami School of Medicine. He received his B.S. degree from the University of Nebraska at Omaha in Speech-Language Pathology with a minor in Deaf Education. His M.A. degree is from Central Michigan University in Audiology. And his Ph.D. degree is from Baylor College of Medicine in Audiology and Bioacoustics. Dr. Fifer's clinical and research interests focus on the areas of auditory evoked potentials, central auditory processing, early detection of hearing loss in children, and auditory anatomy and physiology. He is the immediate Past-President of the Florida Association of Speech-Language Pathologists and Audiologists, a member of ASHA's Health Care Economics Committee, and the ASHA representative to the American Medical Association's Health Care Professions Advisory Committee for the Relative Value Utilization Committee in addition to being ASHA's representative to the AMA's Practice Expense Advisory Committee. Additional responsibilities at the state level include serving as a consultant to the Florida Department of Health's Children's Medical Services and the audiology representative to the Genetics and Newborn Screening Advisory Council.
