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Audiology Today May/June 2023

The American Academy of Audiology promotes quality hearing and balance care by advancing the profession of audiology through leadership, advocacy, education, public awareness, and support of research. Dive into the May/June 2023 Audiology Today issue below!

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PRESIDENT’S MESSAGE | Evolution: Dogs, Humans, and Audiology

The theory is that animals become domesticated when those who have a genetic predisposition to less fear of “others” can take advantage of this trait in a way that promotes survival and are therefore more likely to pass on this genetic trait to their ancestors. Dogs, descendants of wolves, would have evolved when certain wolves who were less fearful of humans began to follow them and live off their scraps.

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Joining Pharmacists on the Over-the-Counter Hearing Aid Journey (charactervectorart/Shutterstock.com and S. Chanesman)

Joining Pharmacists on the Over-the-Counter Hearing Aid Journey

Over-the-counter (OTC) hearing aid legislation and sales have grabbed the attention of audiologists, pharmacists, and consumers over the past few years. Community pharmacists are now interested in contributing to OTC hearing help, in the same way they offer support for safe and effective use of other OTC medications and devices intended for self-care. This article suggests models for collaborative working relationships between audiologists and pharmacists.

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Maximum Conductive Hearing Loss—Revisited

Maximum Conductive Hearing Loss—Revisited

It is the aim of this article to disabuse audiologists and otolaryngologists of the idea that a conductive hearing loss cannot be greater than 60 dB. The article demonstrates that air-bone gaps are both transducer specific and frequency specific and can feasibly be upward of 105 dB.

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Promoting Healthy Aging in the Audiology Clinic (Monkey Business Images/Shutterstock.com)

Promoting Healthy Aging in the Audiology Clinic

People age much differently today compared with previous generations. Known as the healthy aging movement, its focus is on preventive care, health, and wellness. This is an opportunity for audiologists to broaden their appeal to individuals who may not wear hearing aids or even have hearing loss. As this article illustrates, there are several possible strategies that can be used by audiologists to create value for this large group of individuals.

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A Different Lens: Social Determinants of Health and Childhood Hearing Loss

A Different Lens: Social Determinants of Health and Childhood Hearing Loss

Many families of children who are Deaf/hard of hearing experience a litany of nonmedical factors in the environments where they live, learn, work, and play. These conditions, known as social determinants of health (SDOH), warrant further consideration by audiologists. Viewing outcomes through an SDOH lens redefines our work and requires thoughtful consideration of ways to mitigate.

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ON TREND | Sound Bite for Success: Prequalification—An Easy-to-Use Tool to Help Increase Treatment Acceptance

ON TREND | Sound Bite for Success: Prequalification—An Easy-to-Use Tool to Help Increase Treatment Acceptance

We all know that cost is one of the biggest reasons that patients often don’t move forward with the purchase of hearing technology. We also know that financing plays a major role in making comprehensive hearing-health-care products and services more accessible to patients. If patients can fit the cost into their lifestyle and monthly budget, they may be more likely to move forward with purchasing the technology they want and need to help them live a connected life. The CareCredit prequalification process makes it even easier for patients to see if they prequalify for the CareCredit credit card with no impact to their credit bureau score. So, providers now have an opportunity to break down yet another barrier that patients may have and increase access to hearing technology.

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ON TREND | Outsmarting OTC

ON TREND | Outsmarting OTC

The notion of competing against quick-fix over-the-counter (OTC) hearing aids might seem daunting. Daunting, yet not impossible. When you consider the benefits you can offer your patients (quality products, maximized performance, and personalized care), the one-size-fits-all model doesn’t sound nearly as good.

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By Sydney Nance, M.C. Rincon, Andrea Gohmert, and Anna M. Jilla This article is a part of the May/June, Volume 35, Number 3, Audiology Today issue.  As technologies for diagnostic vestibular testing continue to evolve, it is expected that coding and billing for these services will also change. It is important for clinicians to understand how to code and bill for these procedures. We will also discuss newer vestibular assessment methods and appropriate methods of reporting them. The scope of this article will be limited to vestibular diagnostic assessment as many payers do not currently reimburse audiologists for rehabilitative aspects of vestibular care. Identifying Coverage Policies for Vestibular Testing Coverage policies for vestibular assessment will vary by payer, and specifically those in Original Medicare (Part B) will be specific to the local coverage determination in that Medicare regional jurisdiction; a tutorial on identifying local coverage determination processes was provided in a previous issue of Audiology Today (Jilla and Kovar, 2023). Further, benefits through Medicaid or Children’s Health Insurance Program (CHIP) plans will vary from state to state. Clinicians should contact insurers and reference relevant coverage policies to determine coding and billing nuances that may be payer specific. The purpose of this article is to discuss generic coding considerations when filing claims for vestibular assessment procedures. Electronystagmography and Videonystagmography  The Current Procedural Terminology (CPT) code that best encompasses the work involved in electronystagmography (ENG) or videonystagmography (VNG) is the basic vestibular evaluation code (92540). Basic vestibular evaluation (92540) is a bundled code and includes the following component procedures: 92541—Spontaneous nystagmus test including gaze and fixation nystagmus, with recording* 92542—Positional nystagmus test, minimum of four positions, with recording* 92544—Optokinetic nystagmus test, bidirectional foveal or peripheral stimulation, with recording* 92545—Oscillating tracking test, with recording* *Do not bill in conjunction with 92540. When billing for 92540 (basic vestibular evaluation), all four components of the bundled code must be completed for appropriate reporting. For procedures included in the bundled basic vestibular evaluation code (92540), it should also be noted that the positional nystagmus (92542) component of the bundled 92540 requires that positional testing occur with a minimum of four positions (American Academy of Audiology, 2023).  Saccades Saccadic testing is routinely completed as part of ENG and VNG procedures, but the work of this procedure is not accounted for in the bundled 92540 (basic vestibular evaluation) code. There is no CPT code assigned to saccadic testing.  Therefore, 92700 (other otorhinolaryngological service or procedure) can be used to bill for this procedure, and the fee is set by the provider. Code 92770 (electro-oculography) should not be used to report saccadic testing as 92770 is an ophthalmology code and can only be used to document a standard test of the electrical potential originating in the retina.   Use of Modifier for Incomplete ENG/VNG Testing In vestibular assessment, clinicians may find that there are times where the entirety of the bundled, basic vestibular evaluation (92540) cannot be completed due to equipment or patient factors (for example, nausea or inability of VNG equipment to track eye movements due to severe ptosis). When 92540 (basic vestibular evaluation) is not completed as intended in the bundled code description, clinicians should report only the component codes of 92540 that were completed and append a -59 (distinct procedural service) modifier to each component code. When two to three of the component procedures of 92540 are completed, those services may be reported (that is, any 2 or 3 among codes 92541, 92542, 92544, 92545) and the -59 modifier appended to each. Documentation in the medical record should indicate why the bundled code (92540) was not performed (American Academy of Audiology, 2023). (Fotosr52/Shutterstock.com)

CODING AND REIMBURSEMENT | Specialty Series: Vestibular Diagnostic Assessment

As technologies for diagnostic vestibular testing continue to evolve, it is expected that coding and billing for these services will also change. It is important for clinicians to understand how to code and bill for these procedures. We will also discuss newer vestibular assessment methods and appropriate methods of reporting them. The scope of this article will be limited to vestibular diagnostic assessment as many payers do not currently reimburse audiologists for rehabilitative aspects of vestibular care.

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AUDIOLOGY ADVOCATE | “Limited” Direct Access in Medicare: More Work to Be Done!

The proposed CY2023 MPFS was released in July 2022 and included a proposal to allow audiologists to provide certain nonvestibular and nonacute services without a physician order.

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