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CPT Codes for Preventive Care

Kim Cavitt, AuD

February 11, 2013

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Question

We have several patients whose insurance will pay for preventive hearing care.  Are there specific diagnosis codes which should be used when filing these types of claims? We have been told by the carrier that our diagnosis code 388.40 is not a preventive code.  I have been researching the ICD-9-CM books to find a specific code.  Thanks for your help.

Answer

Yes and No.  For follow-up newborn hearing screening testing, you can add the -33 modifier to the procedures performed.  You can learn more about this at https://www.ama-assn.org/resources/doc/cpt/new-cpt-modifier-for-preventive-services.pdf.  This only applies to newborn hearing screening.  For adults, the only options are V72.19 (other exam of ears and hearing) or V80.3 (screening for ear diseases).


kim cavitt

Kim Cavitt, AuD

Owner of Audiology Resources

Kim Cavitt, AuD was a clinical audiologist and preceptor at The Ohio State University and Northwestern University for the first ten years of her career.  Since 2001, Dr. Cavitt has operated her own Audiology consulting firm, Audiology Resources, Inc.  Audiology Resources, Inc. provides comprehensive operational and reimbursement consulting services to hearing healthcare clinics, providers, organizations, buying groups, and manufacturers who want to be better equipped to compete in the managed care and healthcare arenas.  She currently serves on the Board of the Academy of Doctors of Audiology and the State of Illinois Speech Pathology and Audiology Licensure Board.  She also serves on committees through AAA and ASHA and is an Adjunct Lecturer at Northwestern University.


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