Billing and Coding

Question 1

What is the CPT code for CAPD?

Answer 1

92620 (initial 60 minutes)
92621 (each additional 15 minutes)

Question 2

Are the CAPD codes the only timed codes?

Answer 2

Yes

Question 3

Should you use modifiers for the CAPD timed codes?

Answer 3

No
You can add as many 15 minutes as you want, up to a point
92621(x2) - indicates that you used an extra 30 minutes
You still don’t use a modifier if the assessment didn’t take a full hour

Question 4

Does 92557 include immittance (tymps and reflexes)?

Answer 4

No
You need to bill it separately

Question 5

What is the ICD-10 (diagnostic) code for CAPD?

Answer 5

H93.25

Question 6

What is H93.25 also applicable for?

Answer 6

Congenital auditory imperception
Word deafness
Deafness congenital
Auditory processing disorder
Acquired auditory processing disorder (left, right, and bilateral)

Question 7

What does H93.25 exclude?

Answer 7

Mixed receptive-expressive language disorder (F80.2) - speech code
Don’t bill both
They cannot coexist

Question 8

When do you use H93.29-H93.299 (other abnormal auditory perceptions)?

Answer 8

You can use it for something that cannot be measured
Results are normal

Question 9

Is there are primary and secondary codes?

Answer 9

Yes
The primary diagnosis (the disorder that is being evaluated and treated) should be listed first on the claims form
Any other diagnosis is considered secondary

Question 10

Will insurance reimburse for CAPD testing?

Answer 10

No
You will not get any reimbursement from insurance for CAPD testing
You need to charge the patient