Coding for Auditory Brainstem Response Electronystagmography and Otoacoustic Emissions

Q: What code(s) should physicians report for the interpretation component of auditory brainstem response (ABR), Electronystagmography(ENG) and Otoacoustic Emissions (OAE) services?

A: The following CPT codes for ABR, ENG, and OAE services have separately defined technical (TC) and professional (26) components according to the AMA’s Current Procedural Terminology.

• 92541 Spontaneous nystagmus test, including gaze and fixation nystagmus, with recording
• 92542 Positional nystagmus test, minimum of four (4) positions, with recording
• 92543 Caloric vestibular test, each irrigation (binaural, bithermal stimulation constitutes four (4) tests), with recording
• 92544 Optokinetic nystagmus test, bidirectional, foveal or peripheral stimulation, with recording
• 92545 Oscillating tracking test, with recording
• 92546 Sinusoidal vertical axis rotational testing
• 92548 Computerized dynamic posturography
• 92585 Auditory evoked potentials for evoked response audiometry and/or testing of the central nervous system; comprehensive
• 92587 Evoked otoacoustic emission; limited (single stimulus level, either transient or distortion products)
• 92588 Evokedotoacoustic emission; comprehensive or diagnostic evaluation (comparison of transient and/or distortion product otoacoustic emissions at multiple levels and frequencies)

You can report the professional component of the ABR using modifier 26. The audiologist (if he or she is employed by the facility) or the facility would bill the technical component using the TC modifier.

Note: If the physician or physician group owns the audiometric equipment in the office, he or she should not append any modifiers to the CPT codes. In this case, the physician or physician group is entitled to reimbursement of both the professional and technical components.

Reviewed July 2006

Reviewed June 2009