2025 CPT code 92502
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Otolaryngology - Special Otorhinolaryngologic Services and Procedures Medicine Services and Procedures Feed
Otolaryngologic examination performed under general anesthesia.
Modifier 52 (Reduced Services) may be appended if only a portion of a complete otolaryngologic examination is performed (e.g., only examination of the ears).
Medical necessity is established when the patient's condition, age, or behavior makes it impossible to perform a complete otolaryngologic exam without general anesthesia. The examination must be deemed necessary for appropriate diagnosis and management of the condition.
The otolaryngologist is responsible for performing the examination, ensuring the patient's safety under anesthesia, and interpreting the findings.
In simple words: This code covers a doctor's exam of the ears, nose, and throat when the patient is put to sleep with general anesthesia. This is usually necessary for children who won't cooperate, adults who can't handle the exam while awake, or for patients already under anesthesia after an accident.
This CPT code, 92502, reports an otolaryngologic examination conducted under general anesthesia.This is indicated when a patient's condition necessitates general anesthesia for the examination to be completed successfully. This might include uncooperative children, adults who cannot tolerate the procedure while conscious, or trauma victims already under anesthesia. The examination typically includes an otoscopy (ear examination), examination of the nose, and larynx (voice box).
Example 1: A three-year-old child who is highly uncooperative during routine office visits requires general anesthesia to permit a complete otolaryngologic examination to evaluate potential ear infections., An adult patient with a severe developmental disability needs general anesthesia for a thorough examination to diagnose and manage a suspected laryngeal issue due to inability to cooperate., A trauma patient admitted to the emergency department following a motor vehicle accident is already under general anesthesia and needs a complete otolaryngologic evaluation to assess upper airway trauma.
* Operative report detailing the procedures performed and findings.* Anesthesia record indicating the type and amount of anesthesia administered.* Preoperative and postoperative notes addressing the patient's condition and any complications.* Documentation to support medical necessity, justifying the need for general anesthesia.
** This code should only be used when general anesthesia is absolutely necessary for the examination.It should not be used for routine examinations that can be performed without anesthesia.Always ensure that proper documentation is in place to support medical necessity.
- Revenue Code: M5D (Specialist - Other)
- RVU: Information not provided in source data.Refer to current Relative Value Units (RVUs) for the specific year and payer.
- Global Days: Not applicable. This is a diagnostic procedure, not a surgical procedure.
- Payment Status: Active
- Modifier TC rule: Not applicable. This is a professional service.
- Fee Schedule: Fee schedules vary widely by payer and location. Consult relevant fee schedules for historical data.
- Specialties:Otolaryngology, Anesthesiology (for anesthesia administration)
- Place of Service:Operating Room, Inpatient Hospital, Ambulatory Surgical Center