Jennifer Frank

Jennifer Frank

Young boy receiving hearing test

CODING AND REIMBURSEMENT | Specialty Series: Pediatric Assessment

In January 2020, the American Academy of Audiology (the Academy) published its Clinical Guidance Document on the Assessment of Hearing in Infants and Young Children. The document covers four content areas: Pediatric Audiometry, Acoustic Immittance, Otoacoustic Emissions, and Electrophysiologic Audiometry. This article provides guidance on filing claims for pediatric audiometry and electrophysiologic audiometry. Coding for otoacoustic emissions and acoustic immittance are discussed elsewhere (Academy, Pediatric Audiology Billing & Coding Questions & Answers).

Topic(s): Coding, Reimbursement, reimbursment, Pediatric Assessment, Pediatric, Pediatric Audiology, pediatric audiometry, electrophysiologic audiometry, Behavioral Audiometry, Behavioral observation audiometry (BOA), visual reinforcement audiometry (VRA), conditioned play audiometry (CPA), Speech Threshold Audiometry, auditory brainstem response (ABR), auditory steady-state response

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CODING AND REIMBURSEMENT | When and Why to Modify

Billing modifiers were created to provide additional information to the payer about the performed procedure(s) and help describe and/or qualify the services provided. There are common modifiers used by commercial payers and the Centers for Medicare and Medicaid Services (CMS), that indicate to the payer that the services provided have been altered in a way that is different than the ascribed definition of the billing code. For example, a modifier should be used when all of the tests in a bundled code were not performed or when only one ear was tested.

Topic(s): Centers for Medicare and Medicaid Services (CMS), Medicare, Advance Beneficiary Notice (ABN), CPT - Current Procedural Terminology, Coding, Reimbursement, Practice Management, Patient care, Treatment