2025 CPT code 92603
(Active) Effective Date: N/A Revision Date: N/A Evaluative and Therapeutic Otorhinolaryngologic Services - Special Otorhinolaryngologic Services and Procedures Medicine Feed
Diagnostic analysis of a cochlear implant in patients 7 years or older, including initial programming and patient/family counseling.
Modifiers may be applicable depending on the specific circumstances of the service. Consult payer guidelines for appropriate modifier usage.
Medical necessity is established by documentation supporting the need for cochlear implant programming, such as hearing loss, previous surgery, or device malfunction.This documentation must be consistent with the payer's medical necessity guidelines.
The audiologist or otolaryngologist is responsible for performing the analysis, programming, and patient education related to the cochlear implant.
In simple words: The doctor checks a previously implanted hearing device in a patient aged 7 or older. They program the device to work best for the patient and teach the patient and family how to care for it.
This CPT code encompasses the comprehensive post-operative analysis and fitting of a previously implanted cochlear implant in patients aged 7 years and older.The procedure includes connecting the external components (transmitter, microphone, and cable) to the external speech processor, programming the device using computer software, ensuring proper stimulator function and electrode placement within the cochlea, adjusting implant settings (volume, stimulation parameters) according to individual patient needs, and providing patient/family education on device use, care, and maintenance. Data is compiled and recorded.
Example 1: A 10-year-old patient presents for their first post-operative cochlear implant programming session. The provider assesses device function, optimizes stimulation parameters, and educates the patient and family on device maintenance and troubleshooting., An 80-year-old patient with a previously implanted cochlear implant experiences decreased hearing clarity.The provider performs a programming evaluation, adjusts settings, and provides additional instruction on microphone placement and battery care., A 15-year-old patient reports feedback issues with their cochlear implant. The provider diagnoses the problem (loose connection, malfunctioning component), re-programs the device, and educates the patient on how to recognize and prevent similar issues.
* Comprehensive patient history including previous hearing evaluations and cochlear implant surgery details.* Detailed documentation of the programming session, including specific adjustments made to the implant parameters.* Assessment of the patient's response to the programming adjustments and overall device function.* Patient education records documenting discussion of device use, care, and troubleshooting.
** This code is specifically for patients 7 years of age and older.For younger patients, use code 92601 for initial programming and 92602 for subsequent reprogramming.Payers may have specific billing requirements for bilateral cochlear implant programming. Always consult payer guidelines for accurate billing practices.
- Revenue Code: T2D (OTHER TESTS - OTHER)
- RVU: Information not available in provided sources.RVUs vary based on geographic location and payer.
- Global Days: Information not available in provided sources.The global period may vary depending on payer.
- Payment Status: Active
- Modifier TC rule: No specific TC modifier rule identified in sources.Modifier usage should adhere to payer guidelines.
- Fee Schedule: Information not provided. Consult fee schedules from relevant payers for specific information.
- Specialties:Audiology, Otolaryngology
- Place of Service:Office, Outpatient Hospital, Ambulatory Surgical Center