The American Academy of Audiology (Academy) and the American Speech-Language-Hearing Association (ASHA) are pleased to announce the publication of seven new Current Procedural Terminology (CPT ®) codes for auditory-evoked potentials (AEP) and vestibular-evoked myogenic potential (VEMP) services. The American Medical Association (AMA) CPT Editorial Panel approved these codes for implementation on January 1, 2021.
ASHA and the Academy, working with the American Academy of Neurology and the American Academy of Otolaryngology–Head and Neck Surgery, led an effort to replace two AEP testing codes (CPT 92585 and 92586) with four new codes to better define and describe the work being performed for these services. CPT codes 92585 and 92586 are deleted effective December 31, 2020.
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Deleted codes in the AEP family
92585 (Auditory evoked potentials for evoked response audiometry and/or testing of the central nervous system; comprehensive)
92586 (Auditory evoked potentials for evoked response audiometry and/or testing of the central nervous system; limited)
Propose four new codes for AEP testing:
Three new codes related to the assessment of hearing function.
One new code related to the diagnostic assessment of auditory nervous system integrity.
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List of New AEP Codes
The first three of the new AEP codes relate to the assessment of hearing function and the fourth code is specifically designed to report activities related to neurodiagnostic, site of lesion testing (CPT Assistant, 2020). It should be noted that these codes do not reflect new AEP procedures, but more clearly define the work that is involved for each code.
92650—Auditory evoked potentials; screening of auditory potential with broadband stimuli, automated analysis
This code would be reported when using automated testing procedures to determine whether AEP responses are present or absent (pass/refer response). This procedure would be most commonly used in universal newborn hearing screening programs, but may be used under certain circumstances in other places of service for patients who are not newborns.
92651—Auditory evoked potentials; for hearing status determination, broadband stimuli, with interpretation and report
This code would be reported when using non-automated testing procedures for hearing-status determination. Typically, AEP responses to broadband stimuli are obtained at moderate to high levels and at a lower intensity level. The higher levels are used to evaluate the neural integrity of the AEP response (e.g., to rule out auditory neuropathy, sensory or permanent conductive hearing loss). At higher levels, wave-form identification, integrity, absolute and inter-wave latencies are analyzed. The lower stimulus levels are used to identify normal AEP function or to confirm hearing impairment and the need for additional frequency-specific threshold testing (see 92652).
92652—Auditory evoked potentials; for threshold estimation at multiple frequencies, with interpretation and report (Do not report 92652 in conjunction with 92651.)
This code would be reported for activities related to the determination of type, severity, and configuration of hearing loss by measuring the auditory brainstem response (ABR) or auditory steady-state response (ASSR) threshold response at multiple frequencies. Since the higher intensity level waveform analysis described in 92561 is typically performed in conjunction with threshold identification, 92561 should not be reported in conjunction with 92652, as the work of 92561 is accounted for in the valuation of 92652.
92653—Auditory evoked potentials; neurodiagnostic, with interpretation and report
This code would be reported for activities related to neurodiagnostic evaluation of the VIII cranial nerve and/or auditory brainstem. Differentiating characteristics of 92653 and 92651 pertain to the motivations and impetus for testing. For example, if the primary concern is neurologic in nature (e.g., a space-occupying lesion or the integrity of the VIII cranial nerve and/or the auditory brainstem), 92653 would be reported.
The 92653 procedure serves to identify a primary neurologic concern, of which hearing loss may or may not be a secondary concern. It is not appropriate to report 92653 in conjunction with other AEP codes (92651 and 92652), as these procedures are distinct and separate in their descriptions and professional work.
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List of New VEMP Codes
92517—Vestibular evoked myogenic potential (VEMP) testing, with interpretation and report; cervical (cVEMP) (Do not report 92517 in conjunction with 92270, 92518, 92519.)
This code would be reported for evaluation of function of the saccule and inferior vestibular nerve (cVEMP response). Report when only a cVEMP evaluation is performed.
92518—Vestibular evoked myogenic potential (VEMP) testing, with interpretation and report; ocular (oVEMP) (Do not report 92518 in conjunction with 92270, 92517, 92519.)
This code would be reported for evaluation of function of the utricle and superior vestibular nerve. (oVEMP response). Report when only an oVEMP evaluation is performed.
92519—Vestibular evoked myogenic potential (VEMP) testing, with interpretation and report; cervical (cVEMP) and ocular (oVEMP) (Do not report 92519 in conjunction with 92270, 92517, 92518.)
This code would be reported for evaluation of both saccular and utricular function, as well as the superior and inferior portions of the vestibular nerve (cVEMP and oVEMP responses). Report when both cVEMP and oVEMP evaluations are performed.
References:
https://www.audiology.org/practice_management/coding/new-audiology-cpt-codes-2021
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