CPT 92567: Tympanometry Billing, Coding, Reimbursement & Documentation Guide
CPT 92567 is the code for tympanometry, also called impedance testing. It reports a test of middle ear function, and it is frequently billed by audiology and ENT practices. The code looks simple, but claims still stall when the chart does not match the code, a combination code applies, or a payer wants more support. This guide helps audiologists, ENT practices, and billing teams get 92567 claims right.
What Is CPT 92567?
Item | Details |
CPT code | 92567 |
Service | Tympanometry (impedance testing) |
Specialty | Audiology, ENT, and related settings |
Primary purpose | Evaluation of middle ear function |
Billing focus | Correct coding, documentation, medical necessity, and payer requirements |
92567 is not a comprehensive hearing evaluation. Pure tone audiometry and speech testing are different services with their own codes.
What Does Tympanometry Measure?
Tympanometry measures how the eardrum moves as air pressure in the ear canal changes. The result, a tympanogram, helps clinicians assess middle ear function. For billing, what matters is that the test was performed and the result is in the record.
CPT 92567 Billing Guidelines
Strong claims start with the basics: the right code for the service, complete documentation, a clear reason for testing, accurate patient and date of service information, and a check of payer rules. Avoid duplicate or unsupported billing, and confirm provider and facility requirements for your setting. Reporting units and laterality follow CPT and payer instructions, so do not assume.
Before Submitting a 92567 Claim
☐ Was tympanometry actually performed? | ☐ Does the documentation support the service? |
☐ Is the service medically necessary for the patient’s condition? | ☐ Is the diagnosis appropriately documented? |
☐ Has the payer’s current policy been checked? | ☐ Are all claim details accurate? |
☐ Were coding edits and payer requirements reviewed? |
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CPT 92567 Documentation Requirements
Records generally should show who was tested, why, what was done, and what was found. Requirements vary by payer and setting.
• Reason for the test and relevant clinical indication.
• Medical necessity context, such as symptoms or findings.
• The service performed and the results, such as the tympanogram.
• Date of service, provider information, and patient information.
• Clinical assessment where applicable.
CPT 92567 Reimbursement: What Should Practices Expect?
Payment for 92567 is not one universal number. It varies with the payer, geographic location, contracted rates, place of service, patient benefits, medical necessity, coverage policies, claim accuracy, and deductibles and coinsurance. Hospital outpatient payment can also be packaged in some situations, so the setting matters. We do not publish a dollar amount, because any single figure would mislead.
What Can Affect Your 92567 Payment?
Payer | Contract | Coverage | Medical necessity | Documentation | Claim accuracy | Final payment |
This is a simplified pathway. Actual payer processing varies.
Common CPT 92567 Billing Mistakes
Common Mistake | Why It Matters | Better Practice |
Incorrect CPT selection | Can lead to inaccurate claims, such as billing 92567 when reflex thresholds were also tested | Verify the actual service performed |
Weak documentation | Makes medical necessity hard to establish | Document the clinical reason and the service |
Ignoring payer rules | Policies differ | Check current payer requirements |
Diagnosis mismatch | Can trigger review or denial | Ensure documentation supports the diagnosis |
Duplicate billing | May cause payment problems | Review claim history and applicable edits |
Assuming every payer pays the same | Reimbursement varies | Verify contract and payer rules |
CPT 92567 Denials: Why Claims Get Rejected
Reasons vary by payer, but tympanometry claims commonly run into:
• Medical necessity concerns.
• Documentation gaps.
• Coverage limitations.
• Coding errors or edit conflicts.
• Patient eligibility problems.
• Incorrect claim information.
• Duplicate or conflicting billing.
• Missing authorization or referral, when a payer requires one.
92567 Claim Risk Check
How strong is your 92567 claim? Count the boxes you can honestly check.
☐ Service clearly documented | ☐ Medical necessity supported |
☐ Diagnosis matches the clinical documentation | ☐ Payer coverage verified |
☐ Current payer rules reviewed | ☐ Claim information validated |
Score | What It Suggests |
0 to 2 checks | Your claim may need additional review. |
3 to 4 checks | Your process has several safeguards in place. |
5 to 6 checks | Your workflow appears well controlled, but payer specific requirements should still be verified. |
This is an educational self check, not a guarantee of payment.
CPT 92567 vs Other Audiology Testing Codes
Code | General Service | Billing Consideration |
92567 | Tympanometry (impedance testing) | Verify documentation and medical necessity |
92568 | Acoustic reflex testing, threshold | A different test; 92550 combines it with 92567 |
92550 | Tympanometry and reflex threshold measurements | Combination code; do not add 92567 on top |
92553 | Pure tone audiometry, air and bone | Different hearing test |
92555 | Speech audiometry threshold | Different from tympanometry |
92556 | Speech audiometry with speech recognition | Verify the actual service performed |
Important: Code selection should reflect the services actually performed and documented. Always review current CPT guidance, NCCI edits, and payer specific billing requirements before submitting claims. | ||
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CPT 92567 FAQ
What is CPT 92567 used for?
CPT 92567 reports tympanometry (impedance testing), which evaluates how the eardrum and middle ear respond to pressure changes. Practices bill it when tympanometry was performed, documented, and supported by medical necessity.
Is CPT 92567 the code for tympanometry?
Yes. 92567 is the tympanometry only code. If acoustic reflex threshold testing was also performed, a combination code such as 92550 may describe the services instead. Verify current CPT instructions.
What documentation is needed for CPT 92567?
Generally the clinical indication, the tympanogram or recorded results, the date, and provider documentation. Orders and other items vary by payer and setting.
How much does CPT 92567 reimburse?
There is no single amount. Payment depends on the payer, contract, location, place of service, coverage, and patient cost sharing. Check your fee schedules and contracts.
Why might a CPT 92567 claim be denied?
Common reasons include medical necessity concerns, missing documentation, coverage limits, coding edit conflicts, and eligibility or claim data errors. Reasons vary by payer.
Can CPT 92567 be billed with other audiology services?
Sometimes, but it depends on the services performed, NCCI and payer edits, and documentation. Reporting 92567 with codes that already include it, such as 92550, should be avoided.
How can practices reduce tympanometry billing errors?
Match the code to the service documented, verify eligibility and payer rules, scrub claims against edits, and review denials by reason.
Disclaimer: This article is for educational and informational purposes. CPT and payer requirements can change. Coverage and reimbursement vary by payer, plan, location, contract, and patient circumstances. Verify current CPT guidance, payer policies, contracts, and applicable regulatory requirements. This article does not guarantee reimbursement or payment and should not replace professional coding, billing, legal, or compliance advice. |
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