Hearing Impairment Prevalence and Associated Risk Factors in the Hispanic Community Health Study/Study of Latinos

Hearing impairment (HI) is a common problem in adults but there have been few studies of hearing in the U.S. Hispanic/Latino population. Little is known about factors associated with HI among Hispanics/Latinos

Coding and Reimbursement: A Tutorial

ABSTRACT This discussion is a brief overview and tutorial of rationales for accurate selection of procedure (CPT) and diagnosis (ICD-9-CM) codes. The CPT selection procedure is very stringent and is contingent upon finding the code descriptor that describes precisely what was performed. In contrast to the magnitude of precision of the CPT codes, the ICD-9-CM system is incomplete with regard to coding options. For diagnosis code selection, the provider must choose a code that is as close as possible to the evaluation's diagnostic conclusion and patient status. Also included in this tutorial is a brief discussion of the documentation requirements to justify and support the particular codes that were selected

Hearing Aid Reimbursement: A Discussion of Influencing Factors

Abstract Reimbursement for hearing aids in the present time has become as complicated, if not more so, than any other area of health care. For many years, hearing aids were a noncovered item where insurance was concerned. The predominant model of bundling costs into a single dollar amount was copied decades ago from hearing instrument specialists. However, insurance companies and federal agencies are increasingly covering the cost of the diagnostic hearing evaluation and at least some of the costs associated with hearing aid purchases. One operational question is whether the bundled charge model is still appropriate, or should audiologists follow more closely the example of optometry whereby professional services are charged separately from the cost of goods sold? The models that have evolved constitute a broad mixture of bundling, partial bundling (i.e., partial unbundling), and complete unbundling. There exists no uniformity for which charge method is best. But, with greater frequency, insurance requirements are forcing a movement toward partial or complete unbundling of associated costs. Regardless of which charge model is adopted, calculation of the cost of service delivery for each audiology practice is an essential business component to justify charges and make educated decisions regarding participation in various insurance, cooperative, or network plans

Evidence That the Association Between Hypernasality and 22q11 Deletion Syndrome Still Goes Undetected: A Case Study

This manuscript presents a case study that underscores the need for increasing awareness that hypernasality, velopharyngeal insufficiency, and a number of other anomalies may be related through the common etiology of 22q11 deletion syndrome. The child presented here has a long-standing history of cardiac defects, hypernasality, poor speech intelligibility, and other anomalies. The variety of symptoms, occurring over a relatively broad time span, caused the family to seek several individual specialists on separate occasions. A major factor influencing this case was the absence of communication between the various specialists. Each health care specialist treated the child based on the limited perspective of the individual discipline, missing the fundamental etiology of the child’s disorders. It was not until the diagnosis of 22q11 deletion syndrome was established that successful, coordinated treatment of the disorder was realized

Current Procedural Terminology: Where and How Do We Get CPT Codes?

Abstract This tutorial provides the background and rationale for the establishment of the Current Procedural Terminology (CPT) Manual as well as instructions for its beneficial use. Current Procedure Terminology selection procedure is contingent upon finding the code descriptor that describes precisely what is performed. Guidelines and procedures for CPT code development and the process for valuation of new CPT codes are discussed. Also included in this tutorial is a brief discussion of the documentation requirements to justify and support the particular codes that were selected

Myogenic influences on the electrical auditory brainstem response (EABR) in humans

Two cases demonstrating the effects of myogenic artifact on the electrical auditory brainstem response (EABR) when using a promontory stimulation site are presented. Intensity‐response functions were obtained in the unparalyzed condition, then repeated after infusion of a neuromuscular paralyzing agent. In both cases, the myogenic response was observed at lower stimulus intensities than the EABR components. As intensity increased, the myogenic responses grew at extremely rapid rates and made any subsequent identification of auditory responses virtually impossible. To alleviate the adverse influence of myogenic components, general anesthesia and a paralyzing agent must be incorporated into the test protocol when acquiring the EABR using a promontory site of stimulation