ED Coding & Reimbursement Alert - 2014 Issue 38
Audiology: Listen for Medicare Approvals When You Report Audiology Codes
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Article Overview
This article explains Medicare-focused billing and coverage considerations for audiology diagnostic testing. It is aimed at audiologists, physicians, non-physician practitioners, and billing staff who need to understand ordering requirements, professional versus technical components, and CMS guidance for selected audiology services. The discussion includes general CPT audiology coding references and CMS Transmittal 84 considerations.
Why This Topic Matters
Audiology services can be denied or billed incorrectly if ordering, supervision, and component requirements are not understood. This article helps readers identify when Medicare-related approval and provider involvement affect reporting and claim submission for audiology testing.
Article Sections
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Only Schedule Audiology With a Physician Order
Discusses ordering expectations for audiology diagnostic testing and the general involvement of physicians or other qualified providers under Medicare and some commercial plans.
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Look at Professional and Technical Components
Explains the broad CMS framework for audiology services that involve professional and technical components, including supervision and provider participation.
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Get Familiar With the Codes
Introduces selected audiology CPT examples discussed in the article and notes that CMS guidance may affect how these services are handled.
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Exceptions
Describes an exception noted in CMS guidance for one audiology-related procedure and how it is addressed at a general level.
What You Will Learn
- Ordering and referral considerations for audiology diagnostic testing
- How professional and technical components are discussed for audiology services
- Which general types of audiology CPT procedures are referenced in CMS guidance
- Where exceptions to component-based billing are addressed in the article
Who Should Read This
- Audiologists
- Physicians
- Non-physician practitioners
- Audiology billing staff
- Medical coding professionals
Codes Discussed
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