2025 CPT code 92700
(Active) Effective Date: N/A Revision Date: N/A Otorhinolaryngology - Special Otorhinolaryngologic Services and Procedures Medicine Services and Procedures Feed
Unlisted otorhinolaryngological service or procedure.
Modifiers may be applicable depending on the specific circumstances of the service.Consult the CPT manual and payer guidelines for appropriate modifier usage.
Medical necessity must be clearly established and documented. This requires clear evidence that the procedure or service was appropriate and necessary for the patient's diagnosis and treatment. Supporting documentation should clearly link the provided service to the patient's condition and medical history.
The clinical responsibility falls on the otorhinolaryngologist performing the unlisted procedure.This includes pre-operative evaluation, the procedure itself, post-operative care and follow-up, and accurate documentation of the service.
In simple words: This code is for ear, nose, and throat procedures or services that don't have a specific code.Doctors use it when they do something unusual or new, and need to explain exactly what was done.
This CPT code is used to report any otorhinolaryngological service or procedure that does not have a specific code in the CPT code set.It is used when a unique or innovative procedure is performed, or when existing codes do not adequately describe the service provided.Comprehensive documentation, including a detailed description of the procedure performed, justification for using this unlisted code, and comparison to similar coded procedures, is crucial for proper reimbursement.
Example 1: A patient presents with a rare foreign body lodged in the middle ear requiring a specialized surgical technique not covered by existing CPT codes.Code 92700 would be used with detailed procedural notes., An audiologist performs a novel auditory processing test to assess a specific cognitive deficit not captured by current CPT codes. Code 92700 is utilized, along with a comprehensive description of the test methodology and results., A surgeon develops a new surgical approach to treat a specific type of vocal cord lesion. The surgeon uses code 92700, providing detailed operative notes, including illustrations, videos, and a comparison to related, coded procedures.
* Detailed description of the procedure or service performed.* Justification for using an unlisted code.* Comparison to similar, existing CPT codes.* Operative notes (if applicable).* Pre- and post-operative diagnoses.* Patient demographics and relevant medical history.* Any specific equipment or materials used.
** Accurate and detailed documentation is paramount when using CPT code 92700.Failure to provide sufficient supporting documentation can lead to claim denials.Always consult payer-specific guidelines for reimbursement policies.
- Revenue Code: P6D (Minor Procedures - Other)
- RVU: RVUs vary significantly depending on the specific unlisted procedure and payer.Detailed documentation is critical for determining appropriate reimbursement.
- Global Days: The global period depends entirely on the nature of the unlisted procedure.Documentation should specify the relevant time frame for postoperative care, if applicable.
- Payment Status: Active, but reimbursement varies significantly by payer and procedure.Detailed documentation is essential for claim approval.
- Modifier TC rule: A technical component (TC) modifier may or may not be applicable, depending on whether the procedure can be separated into professional and technical components. This requires detailed analysis of the service performed and the applicable payer regulations.
- Fee Schedule: Historical fee schedules for 92700 are not standardized, as reimbursement is heavily dependent on the specific service and payer. It is essential to consult payer-specific guidelines and historical data for individual cases.
- Specialties:Otorhinolaryngology, Audiology
- Place of Service:Office, Hospital (Inpatient or Outpatient), Ambulatory Surgical Center, Other