Question #1. Is the audiologist responsible for explaining the test results to the patient and making follow-up (case management) recommendations?  What is “the evaluation and management” (E&M) component of a CPT (current procedural terminology) code?  Is that E&M component bundled into the billing of the audiology code?  Must you explain the results in order to bill for the procedure?

Presume that your patient is a 65 year old male who reports that the right ear has had gradual, likely progressive hearing loss. He had his hearing tested “some years ago” and was advised he could use a hearing aid, but was not inclined since his left ear was normal.  He has recently had sinus congestion, aural fullness left, and decreased hearing left, which is the reason for the hearing test.  He reports tinnitus, right ear only, which he has adapted to.  He denies dizziness, but notes he needs to keep a night light on or else he tends to stumble in the dark.

Question #2.  Review the basic audiometric and immittance findings below.  What information is the minimum that MUST be conveyed in order to honor one’s professional responsibility for guiding the patient?  List these concepts.

NU-6 half lists, recorded

Thresholds

Reflex Decay

CNT Left contra.  CNT right contra due to high stimulus level needed.  500 Hz right contra showed decay to 50% point at 6 seconds after the stimulus started.