- 92557 (comprehensive audiometry) already includes pure-tone air/bone (92553) and speech recognition (92556) - billing the components separately triggers NCCI bundling denials.
- 92567 is tympanometry (impedance testing); 92587 is a limited/distortion-product OAE, while 92588 is the comprehensive OAE evaluation.
- Medicare requires a physician (or NPP) order and a diagnostic medical-necessity reason for covered audiology testing.
- Routine hearing screenings and hearing-aid evaluations are generally NOT covered by Medicare - bill those as patient responsibility.
- Modifier 26/TC errors and missing orders are top audiology denials; many bundled codes cannot be split into professional/technical components.
Audiology tests live in tightly bundled CPT families, Medicare coverage hinges on an order and a diagnostic reason, and a single misplaced 26/TC modifier can sink a claim. This guide walks through the core audiology CPT codes - 92557, 92567, 92587 and their neighbors - and shows exactly where claims fail and how to fix them.
CPT 92557: comprehensive audiometry
92557 is comprehensive audiometry threshold evaluation and speech recognition. By AMA definition it is a combination code that includes the work of 92553 (pure-tone audiometry, air and bone) plus 92556 (speech audiometry threshold with speech recognition). When you perform the full evaluation, report 92557 alone. Reporting 92553 and 92556 separately on the same day trips NCCI edits - the components bundle into 92557.
CPT 92567: tympanometry
92567 is tympanometry (impedance testing) - an objective measure of middle-ear function. It is separately reportable alongside 92557 when both are medically necessary. If you also perform acoustic reflex testing, look to 92550, which bundles tympanometry and reflex threshold measurements into a single code; do not also report 92567 separately when 92550 captures the service.
CPT 92587 vs 92588: otoacoustic emissions (OAE)
92587 is a limited evaluation - distortion-product or transient evoked otoacoustic emissions confirming the presence or absence of a hearing disorder across roughly 3-6 frequencies, with interpretation and report. 92588 is the comprehensive diagnostic evaluation - quantitative cochlear mapping across a minimum of 12 frequencies, with interpretation and report. Choose the code by the breadth of the study performed.
Audiology CPT code reference table
| CPT code | Test | Components / scope | Medicare coverage note |
|---|---|---|---|
| 92557 | Comprehensive audiometry | Bundles 92553 (air/bone) + 92556 (speech) | Covered with order + diagnostic reason; do not unbundle |
| 92553 | Pure-tone audiometry, air and bone | Component of 92557 | Bundles into 92557 when full eval performed |
| 92556 | Speech audiometry threshold w/ recognition | Component of 92557 | Bundles into 92557 when full eval performed |
| 92567 | Tympanometry (impedance) | Middle-ear function | Separately reportable when medically necessary |
| 92550 | Tympanometry + acoustic reflex | Bundles tymp + reflex threshold | Has no separate 26/TC components |
| 92587 | OAE, limited (DPOAE/TEOAE) | ~3-6 frequencies, presence/absence | Covered when diagnostic, not for routine screen |
| 92588 | OAE, comprehensive | >=12 frequencies, cochlear mapping | Covered when diagnostic; scope must match |
Professional vs technical components (26 / TC)
Modifier 26 reports the professional component (interpretation and report); modifier TC reports the technical component. These apply only when a code is split into both components and the work is divided between entities. Many audiology codes, including 92550 and the global audiometry codes, are not split into separate professional and technical components, so appending 26 or TC produces a denial. Confirm a code's PC/TC indicator in the Medicare Physician Fee Schedule before splitting it.
Medicare coverage, orders, and medical necessity
Medicare covers diagnostic audiology when two conditions are met: there is a physician or non-physician practitioner order, and the test is performed for a diagnostic medical-necessity reason - to evaluate a sign or symptom such as hearing loss, tinnitus, or vertigo. Medicare generally does not cover routine hearing screenings or hearing-aid evaluations; those are billed as patient responsibility. (Note: a limited set of non-acute diagnostic audiology services may be furnished by audiologists without a physician order under specific Medicare rules using modifier AB - verify the current policy and annual cap.)
Common audiology denials and how to fix them
| Denial reason | Why it happens | The fix |
|---|---|---|
| Routine screening - no medical necessity | Test billed without a diagnostic sign/symptom | Document the diagnostic reason; bill non-covered screenings as patient responsibility |
| NCCI bundling (92557 + 92553/92556) | Components reported alongside the comprehensive code | Report 92557 alone when the full evaluation is performed |
| Missing physician order | No order on file for the diagnostic test | Obtain and retain the ordering provider's order before testing |
| Modifier 26/TC error | 26 or TC appended to a code with no separate components | Check the PC/TC indicator; remove the modifier on global-only codes |
| OAE scope mismatch (92587 vs 92588) | Comprehensive code billed for a limited study | Match the code to frequencies tested and documentation |
Frequently asked questions
92557 is comprehensive audiometry threshold evaluation and speech recognition. It is a combination code that includes the work of 92553 (pure-tone air and bone) and 92556 (speech audiometry threshold with speech recognition). When you perform the full evaluation, report 92557 by itself.
No. Under NCCI edits, 92553 and 92556 bundle into 92557 when the complete comprehensive evaluation is performed. Reporting them separately on the same day triggers a bundling denial.
92587 is a limited otoacoustic emissions test (roughly 3-6 frequencies). 92588 is the comprehensive OAE evaluation - quantitative cochlear mapping across a minimum of 12 frequencies. Bill the code that matches the scope actually performed.
Generally no. Medicare covers diagnostic audiology only when there is an order and a diagnostic medical-necessity reason such as hearing loss, tinnitus, or vertigo. Routine screenings and hearing-aid evaluations are typically billed as patient responsibility.
They apply only to codes split into both professional and technical components. Many audiology codes, including 92550 and the global audiometry codes, have no separate components, so appending 26 or TC causes a denial. Verify the PC/TC indicator in the Medicare Physician Fee Schedule first.