CPT® Code 92587

Hi, I am receiving a denial from mcd for CPT® code 92587 stating "this procedure is not normally performed for members in this age range". I searched in the descirption of this CPT® code but nowhere mentioned about the appropriate age this procedure should be done. Can anyone tell me the age range for this procedure? Any help would be appreciated. Thank You...

screening

http://www.infanthearing.org/financing/index.html

from AAP

An infant is born to parents who both have hearing loss greater than 90 dB. The newborn hearing screen is normal, with no indication of hearing loss. There is a significant family history of congenital hearing loss in both families. Patient is recommended by the hospital hearing screener for repeat hearing testing at 6 months.

CPT® Coding:
92587 Evoked otoacoustic emissions; limited (single stimulus level, either transient or distortion products; ICD-9-CM Coding: V72.1 Examination of ears and hearing (normal)- Link to 92587

Note: Payers may inappropriately bundle this procedure into the hospital care E/M code.

Six months later, patient sees hospital screener for repeat hearing testing. Options might include automated brain response (auditory evoked potentials) versus sound booth testing as OAE testing not possible in the active child. Because of the family history, parents are offered a referral to a geneticist for testing for the Connexin 26 gene and subsequent genetic counseling. Referral to an early intervention agency is provided so communication issues can be addressed as parents sign only and have no oral speech.

CPT® Coding:
92586 Auditory evoked potentials for evoked response audiometry and/or testing of the central nervous system, limited
or
92551 Screening test, pure tone only

ICD-9-CM Coding:
V72.1 Examination of ears and hearing (normal) Link to 92586 or 92551

re: from AAP

Which DX codes can be used if this service is provided to the Patient who is adult or more than 90 days of age ?

re: from AAP

Based on documentation and medical necessity:
315.34 Speech and Language Development Delay due to Hearing Loss;
315.39 Articulation Errors;
384.20 History of Tympanic Membrane Perforation, Perforation of the Tympanic Membrane, Unspecified;
389.9 Unspecified Hearing Loss;
783.42 Delayed Milestones, Late Talker;
V72.11 Encounter for hearing examination following a previously failed hearing screening;
V72.19 Examination of ears and hearing

re: CPT® Code 92587

Did you ever find an answer to age restrictions for 92587? One Medicaid plan is denying for that reason, others pay it without question. I have heard in some states Medicaid allows the code only til age 5 - but I have spent hours trying to get Amerigroup to commit to an age limit or plan policy. All I know is "pre-certification is not required".