CPT Code 92551: Pure Tone Audiometry Screening

What is CPT code 92551?

CPT code 92551 is a procedural code maintained by the American Medical Association used to report a basic automated hearing screening test. Specifically, it covers a screening test using pure tone air conduction without interpretation or a detailed report. This test is often the first step in identifying whether a patient might have a hearing loss that warrants further evaluation.

This code is commonly used by audiologists, primary care providers, school nurses, and occupational health professionals. It is performed using calibrated electronic equipment that delivers sound stimuli to detect the patient’s response threshold. If abnormalities are detected, the patient may be referred for more comprehensive audiology services such as threshold testing or bone conduction assessment.

What is a pure tone audiometry screening test?

A pure tone audiometry screening test is a quick and non-invasive method of determining whether a person can hear tones at various frequencies and intensities. The test is automated and uses pure tones transmitted via air conduction through headphones or insert earphones. The patient is asked to respond when they hear the tone.

This type of hearing test helps detect early signs of conductive hearing loss, which may arise from conditions such as otitis media or impacted cerumen, as well as issues related to ototoxic medications. The screening is typically performed bilaterally unless clinical indications limit testing to one ear only.

CPT code 92551 documentation requirements

To justify billing CPT 92551, the provider must clearly document the nature of the screening. The following elements should be included in the patient’s record:

Reason for hearing screening

Document the clinical rationale, such as routine school screening, occupational health surveillance, or symptoms of unspecified hearing loss.

Testing method (pure tone air conduction)

State that the screening was performed using a test of pure tone air conduction and confirm the use of calibrated electronic equipment.

Results (pass/fail by ear)

Record the result for each ear—left ear and right ear—indicating whether the patient passed or failed the screening.

Provider performing the screen

Indicate the qualified healthcare professional or technician who administered the test.

Need for follow-up if screening failed

If a patient fails the screening, note the medical necessity for referral to a diagnostic audiologic evaluation or ENT consult.

CPT code 92551 billing guidelines

Proper billing of CPT code 92551 requires adherence to the following principles to avoid denials or compliance issues:

Screening only—does not include threshold determination

CPT 92551 is strictly a screening test of pure tone air conduction and does not include determination of hearing thresholds. If threshold testing is needed, a separate code should be used.

Interpretation/report is not separately reimbursed

This code does not include an interpretation or a report. If these services are provided, they are not billable under 92551.

Use separate codes for diagnostic tests

For full diagnostic testing, including bone conduction or speech audiometry, report codes like 92552 through 92557 instead.

Applicable modifiers for CPT code 92551

While CPT code 92551 generally does not require modifiers, certain billing circumstances may necessitate one:

• Modifier 52 (Reduced services): Use when the screening is conducted on one ear only. For example, Nevada Medicaid restricts use of this modifier to unilateral testing.
• Modifier 76 (Repeat procedure by same physician): Append if the test is repeated on the same date by the same provider.
• Modifier 77 (Repeat procedure by another physician): Use if a different provider performs the repeat test on the same day.
• Modifier 59 (Distinct procedural service): Apply this modifier if CPT 92551 is performed independently of other services on the same date.
• Modifier 91 (Repeat clinical diagnostic laboratory test): Though rare, this may be used when the test must be repeated due to clinical needs, based on medical necessity.

Note that technical components are inherent in CPT 92551, and no separate billing for equipment or facility services is applicable unless otherwise specified by payer policy.

Other relevant CPT codes

Providers should consider related audiologic function codes when services go beyond basic screening:

• 92552 – Pure tone audiometry (threshold), air only: Used when assessing hearing thresholds, not just screening.
• 92553 – Pure tone audiometry (threshold), air and bone: Includes both air and bone conduction thresholds.
• 92556 – Speech audiometry, complete: Used for assessing speech recognition and discrimination.
• 92557 – Comprehensive audiometry threshold evaluation and speech recognition: A bundled diagnostic procedure beyond simple screening.
• 92620 – Auditory function evaluation; first 60 minutes: Applies to extended audiology services.

These codes reflect higher-level diagnostic services beyond CPT 92551 and may apply when the initial hearing test suggests hearing loss.