Basics of CPT code 92622 & 92623
For the CPT 2024 code set, two new Category I codes (92622, 92623) have been established to report analysis, programming, and verification of an auditory osseointegrated sound processor. This article provides an overview of the intent and use of these new codes.
92622 Diagnostic analysis, programming, and verification of an auditory osseointegrated sound processor, any type; first 60 minutes
+92623 each additional 15 minutes (List separately in addition to code for primary procedure)
(Use 92623 in conjunction with 92622)
There are currently no codes available that adequately describe the activation, programming, and verification of auditory osseointegrated devices (AODs) designed for conductive or mixed-hearing disorders or single-sided deafness. For the CPT 2024 code set, codes 92622 and 92623 have been established to describe these services associated with AODs, which are Food and Drug Administration (FDA)-approved, bone-conduction hearing devices designed to stimulate the cochlea directly through skull vibration.
AODs (fully implanted, semi-implanted, or transcutaneous) are medically indicated for hearing disorders related to the outer and/or middle ear that are unresponsive to medical treatment or inoperable. These devices are also approved as a treatment for single-sided deafness. The AOD must be activated, programmed, and verified to ensure that it is meeting the unique needs of the patient.
The following clinical examples and procedural descriptions reflect typical clinical scenarios for which these new codes would be appropriately reported.
A 56-year-old male presents with chronic otitis media resulting in otorrhea and mixed-hearing loss, and the former symptom prevents him from using traditional air-conduction hearing aids. An osseointegrated implant for an auditory osseointegrated device was placed to allow for bone-conducted sound delivery. Patient has returned for device activation, programming, and verification of the sound processor.
Description of Procedure (92622)
Records are reviewed, including applicable pre-implant and intra-operative reports and audiometric findings. The patient’s demographic data and audiometric results are entered into the device programming software, the external sound processor is connected to the programming software, and the desired device parameters for the hearing configuration are selected.
The qualified health care professional meets with the patient and provides a review of the procedure. After determining the method and location where the external sound processor will be affixed to the patient’s head, the external sound processor is fitted to the patient and is adjusted for a secure fit. The qualified health care professional performs a feedback calibration and makes any necessary adjustments to the frequency response and gain of the device for optimal performance.
The integrity of the external processor’s performance is verified by in-situ measurement of bone conduction audiometric values. Additional programming adjustments are made if indicated. The qualified health care professional prepares and programs the sound processor for use with other hearing assistive technology, if indicated. The finalized settings are exported into the external processor. The qualified health care professional prepares a report of the analysis, programming, and verification.
The patient and family are provided information on the device function and maintenance, along with troubleshooting strategies. The test data compiled and stored in the medical record, and the report is sent to the referring provider.
Clinical Example (92623)
A 56-year-old male presents with chronic otitis media resulting in otorrhea and mixed hearing loss, and the former symptom prevents him from using traditional air conduction hearing aids. An osseointegrated implant for an auditory osseointegrated device was placed to allow for bone-conducted sound delivery. The patient has returned for device activation, programming, and verification of the sound processor and requires an additional 15 minutes of service beyond the first hour. [Note: This is an add-on code. Only consider the additional work related to the primary service.]
Description of Procedure (92623)
The QHP continues to make necessary adjustments to the frequency response and gain of the device for optimal performance. The integrity of the external processor’s performance is verified by in-situ measurement of bone conduction audiometric values. Additional programming adjustments are made if indicated. The qualified health care professional prepares and programs the sound processor for use with other hearing assistive technology. The finalized settings are exported into the external processor.
Use of AB Modifier with CPT code 92622 and 92623
There are 36 audiology codes designated to be eligible to use with the AB modifier once every 12 months. It should be used only when the patient has come directly to you without a physician or NPP order.
You may use modifier AB only once every 12 months, regardless of the number of applicable CPT codes billed with the modifier on that date of service. For example, if you billed any one CPT code with AB modifier on a specific date, than none of the other 36 applicable CPT code will not qualify for payable under PFS for another 12 months without a qualifying physician or NPP order.
After getting care from an audiologist they accessed directly, the patient needs to wait 12 months before getting additional diagnostic tests from an audiologist without a physician or NPP order. During this interim period the patient may seek care from their treating physician or NPP that could result in a referral to an audiologist for diagnostic testing.
Reference: CPT assistant November month