Business of Audiology Flashcards
What are the aural rehabilitation CPT codes?
92626 - evaluation of auditory function for surgically implanted devices, candidacy or post-operative status of a surgically implanted device; first hour
92627 - same as 92626 but for each additional 15 minutes
When is it appropriate to use 92626 and 92627?
These codes are ONLY be used for candidacy and post-operative evaluation of an implantable auditory prosthetic device
Cochlear implant
Auditory osseo-integrated device
Auditory brainstem implant
Evaluation will determine the need for auditory rehabilitation following the fitting and verification of devices and may also be used to monitor the progress of therapeutic intervention
Can I use 92626 and 92627 with commercial payers?
Commercial payers may have different policies on coverage of the evaluation of aural rehabilitation status
Review coverage policies and individually verify if a commercial insurance reimburses for these CPT-4 codes
Note - coverage policies may vary by type of plan for the same payer
Are most audiology CPT codes contact based?
Yes
Reimbursement doesn’t take into account time spent with patient
There are some timed codes (for CAPD testing too)
When can you bill 92627 increments?
15-minute unit has to be a minimum of 8 minutes, no more than 22 minutes
1 unit= 8 to <23 minutes
2 units = 23 to <38 minutes
3 units = 38 to <53 minutes
4 units = 53 to <68 minutes
5 units = 68 to <83 minutes
6 units = 83 to <98 minutes
How do you bill these codes if the evaluation lasts less than an hour?
You cannot bill if you spent less than 31 minutes with the patient doing these assessments
Document
Code 92626 should not be reported for evaluations of auditory function lasting less than 31 minutes
Should you document for timed CPT codes?
Yes
Document the face-to-face start & end time in patient records
SOAP progress note sections:
Subjective findings gathered
Objective studies and test results
Assessment of clinical findings
Plan of care/recommendation
Signature; date & time of service
Note - this will not be the same as the scheduled appointment time
*Required to support an audit
What codes are currently not reimbursable to audiologists?
92633 - auditory rehabilitation, post-lingual hearing loss
92630 - auditory rehabilitation, pre-lingual hearing loss
*available for SLPs to bill, may not be the case for private insurance
Do recommendations of group AR programs remain low?
Yes, despite evidence of benefit
What is the ACHIEVE study?
A multicenter randomized trial to determine if treating hearing loss in older adults reduces the loss of thinking and memory abilities (cognitive decline) that can occur with aging
Participants from two populations: a group of healthy volunteers from the community (739) and a group of adults participating in a heart health study (238)
What were the findings from the ACHIEVE study?
Hearing intervention DID NOT change the rate of cognitive decline significantly over 3 years in the healthy volunteers group
Hearing intervention PROVIDED SIGNIFICANT BENEFITS the heart healthy group of subjects (cognitive decline reduced by 48%) - hearing aids can assist in preventing cognitive decline in those with multiple comorbities (some of which might impact the auditory system)
Does ACHIEVE report a correlation between the degree of hearing loss, loneliness, social network size, and SNR loss?
Yes
Speech-in-noise measures closely capture hearing ability in real-world settings by capturing both the bottom-up processing and top-down processing needed to perceive & understand speech in the presence of competing noise
Social interactions commonly take place in settings where background noise is present (eg, restaurants and social gatherings) and the ability to communicate in these settings may be important to developing and maintaining social relationships
Is hearing loss associated with poorer health in older adults?
Yes
A study was done to find out
A 10 dB increase in PTA was associated with a 52% increased odds of social isolation among 60- to 69-year-olds
Was there another ACHIEVE protocol?
Yes
This one’s objective was to minimize activity limitations & participation restrictions due to hearing impairment
What was the pre-fitting protocol for the ACHIEVE protocol?
Conduct an individual communication needs assessment
Spend time developing individual rehabilitation goals
Engage in shared-informed decision-making (PCC; FCC)
Develop of self-management abilities for hearing loss and communication in real-world settings:
Understanding hearing loss
Realistic expectations
Communicating in background noise
Use of communication strategies, tactics, and resources for PHL and their CP
What was the fitting protocol for the ACHIEVE protocol?
Bilateral RIC aids
Fit to NAL-NL2 prescriptive targets using real-ear measures
Specifically, probe microphone measurements verified REARs from a 65 dB SPL
Operational tolerance ranges were within +5 and −8 dB of targets from 250 to 3000 Hz and within +10 and −13 dB at 4000 Hz
Hearing assistive technologies (HAT) paired with the hearing aids
What was the follow-up protocol for the ACHIEVE protocol?
Self-directed rehabilitation (hearing aid toolkit - C2Hear)
Contains four rehabilitation sections (hearing loss and your listening goals, communication strategies, hearing and understanding in noise, and what are hearing assistive technologies)
Reinstruction in use of devices and hearing rehabilitative strategies is provided during booster visits held every 6 months.
Communication partners are encouraged to attend hearing intervention sessions as part of the intervention
