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2025 CPT code 92591

Hearing aid examination and selection; binaural.

Follow the CPT coding guidelines, specifically those related to audiometric testing and the use of modifier 52 for reduced services.

Modifier 52 (reduced services) may be appended if the hearing aid examination and selection is performed on only one ear instead of both.

Medical necessity is established when a patient presents with hearing loss that significantly impairs their ability to communicate effectively in daily life. The hearing aid examination (92591) is medically necessary to assess the severity of hearing loss, identify any underlying medical conditions contributing to the hearing loss, and determine if hearing aids are appropriate and beneficial.

The audiologist or otolaryngologist is responsible for conducting a thorough hearing evaluation, including patient history, physical examination, and recommendations for hearing aid use. This may include determining the type and style of hearing aid most suitable for the patient's needs and hearing loss.

IMPORTANT:Use 92590 for monaural (one ear) hearing aid examination and selection.HCPCS codes V5010, V5011, V5020, V5090, V5110, V5160, V5200, V5240, and V5241 may also be relevant depending on the services provided (hearing aid fitting, orientation, checking, verification, validation, and dispensing fees).

In simple words: The doctor checks both of your ears to see if hearing aids would help.This includes a health history, ear exam, and recommendations for hearing aids if needed.

This CPT code encompasses a comprehensive hearing aid assessment for binaural (both ears) hearing aid use.The evaluation includes a general health history, review of current medications, childhood illnesses, and a detailed discussion of the patient's hearing loss symptoms. A physical examination of both ears is performed, typically involving otoscopy (inspection of the ear canal and eardrum using an otoscope) to identify any underlying conditions contributing to the hearing impairment (e.g., cerumen impaction, perforation of the tympanic membrane, signs of infection). Based on the findings, the provider recommends appropriate treatment options if medically feasible; otherwise, recommendations for suitable hearing aid types are provided to address the patient's specific hearing needs.

Example 1: A 65-year-old patient presents with progressive bilateral hearing loss. The provider performs a comprehensive hearing aid examination (92591), including otoscopy, history, and discussion of hearing aid options.The provider recommends bilateral behind-the-ear (BTE) hearing aids., A 72-year-old patient reports difficulty hearing conversations in noisy environments. After a detailed hearing aid examination (92591), the audiologist determines that the patient needs bilateral in-the-canal (ITC) hearing aids to improve speech understanding in challenging listening situations., A 40-year-old patient with a history of noise-induced hearing loss undergoes a hearing aid examination (92591). The examination reveals mild-moderate bilateral sensorineural hearing loss. The audiologist recommends bilateral custom-fit hearing aids tailored to the patient's specific hearing needs and lifestyle.

* Detailed patient history, including onset and progression of hearing loss, relevant medical history, and current medications.* Otoscopic findings for both ears.* Audiometric test results (if performed separately).* Discussion of hearing aid options and recommendations.* Patient education and counseling regarding hearing aid use.* Documentation of informed consent.

** This code should not be billed with codes for basic hearing tests (e.g., whispered voice test, tuning fork tests) which are considered part of the evaluation and management service.The use of HCPCS codes for hearing aid fitting, dispensing, and follow-up services should be carefully considered and appropriately documented.

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