2025 CPT code 92627
(Active) Effective Date: N/A Medicine - Special Otorhinolaryngologic Services and Procedures Feed
Evaluation of auditory function for surgically implanted device(s) candidacy or post-operative status; each additional 15 minutes (List separately in addition to code for primary procedure).
Modifiers may be applicable. Modifier 53 may be used if the procedure is discontinued. Modifiers 76, 77, 78 and 79 can be used for repeat procedures by the same or different physicians.Modifiers 58, LT, RT may also be applicable.
Medical necessity for this code must be established by demonstrating the need for evaluation related to candidacy for or post-operative management of a surgically implanted hearing device. The documentation must support that the evaluation is necessary for the diagnosis or treatment of a hearing condition.
The physician assesses the patient's auditory function, including sound awareness, differentiation of sounds, listening abilities in quiet and noisy environments, and overall hearing ability.This information is used to determine the effectiveness of an existing implanted device or to decide if the patient is a candidate for such a device. The service must include face-to-face time with the patient or family.
In simple words: The doctor performs hearing tests to see if you would benefit from a surgically implanted hearing device or to check how well an existing one is working. This code covers every 15 minutes of testing after the first hour.
This code describes the evaluation of a patient's auditory function to determine candidacy for a surgically implanted hearing device (e.g., cochlear implant) or to assess the post-operative status of such a device. It includes sound perception testing, listening ability assessment, orienting movements, and balance evaluation. This code is used for each additional 15 minutes of evaluation beyond the first hour (code 92626).
Example 1: A patient with severe hearing loss is being evaluated for a cochlear implant. The initial evaluation (92626) takes 75 minutes. The additional 15 minutes are billed as 92627., A patient with a cochlear implant returns for a post-operative check-up. The evaluation takes 1 hour and 45 minutes. The provider bills 92626 for the first hour and two units of 92627 for the additional 30 minutes (two 15 minute increments)., A patient with single-sided deafness is considering a bone-anchored hearing aid. The audiologist conducts a comprehensive auditory evaluation that extends to 1 hour and 30 minutes. The first hour is coded as 92626, and the additional 30 minutes (two 15 minute increments) as 92627 x2.
Documentation should include the total face-to-face time spent with the patient or family during the auditory function evaluation, detailed results of the tests performed (including specific tests used, such as sound perception, listening ability, orienting movements, and balance assessments), and a clear explanation of the medical necessity for the evaluation (e.g. pre- or post-operative assessment for a surgically implanted hearing device).
- Revenue Code: T2D - OTHER TESTS - OTHER
- Specialties:Audiology, Otolaryngology
- Place of Service:Office, Outpatient Hospital, Inpatient Hospital