All codes
G526
G526 – Pure tone threshold audiometry and speech reception threshold and/or speech discrimination scores - professional component
OHIP Diagnostic & Therapeutic Procedures Code — DIAGNOSTIC AND THERAPEUTIC PROCEDURES · Schedule of Benefits
The professional component of a basic diagnostic hearing test that includes pure tone threshold audiometry (with or without bone conduction) and speech reception threshold and/or speech discrimination scores. This service covers the physician's interpretation of the test results and the generation of a report. The corresponding technical component is billed as G441.
When to Use
- Use G526 when you have personally interpreted the pure tone and speech audiometry results performed by your staff and generated a formal report for the patient's chart.
- Use this code for the professional component when the technical component is billed simultaneously using G441.
Common Pitfalls
- Submitting G526 on the same day as G450 will result in a zero-dollar payment for G526 due to the explicit billing restriction.
- Billing G526 without a corresponding G441 claim for the technical component often triggers audit flags regarding the completeness of the diagnostic service.
Billing Tips
- Ensure your clinical note explicitly references the interpretation of both pure tone thresholds and speech discrimination scores to justify the professional component fee.
Provider Fee$16.45
Effective: April 1, 2025
Category
J. Diagnostic and Therapeutic Procedures
Subcategory
DIAGNOSTIC AND THERAPEUTIC PROCEDURES
Service Type
Diagnostic
Code Classes
Diagnostic and Therapeutic Procedures
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