Does 92585 require prior authorization?

No, 92585 does not require prior authorization (high confidence). Code is covered without prior authorization.

`92585`

HCPCS/CPT

No Prior Auth Required

Code is covered without prior authorization (high confidence)

Medical record documentation of a complete history and physical examination.
Documented parent/child interview or patient interview containing DSM-5 diagnostic criteria and findings.
Results of collateral assessments when available (for example, Vanderbilt or Conners questionnaires).
Psychiatric evaluation report or clinical notes from psychiatrist, psychologist, or other behavioral health professional.

Automated auditory brainstem responses (ABR), evoked otoacoustic emissions (OAE), or OAE followed by ABR testing is consideredmedically necessaryto screen for hearing disorders foranyof the following indications:
As initial screening for newborns and infants;or
Infants (age less than 1 year) admitted to an ICU for 2 or more days;or
Neonates during the 1st month of life when exposed to potential causes of hearing loss (for example, chemotherapy, hyperbilirubinemia that requires exchange transfusions, meningitis, or culture-positive sepsis);or
To screen for hearing disorders in infants and children when behavioral audiometry is not reliable related to, but not limited to, inability to cooperate with other methods of hearing testing;or
To screen for hearing disorders in children less than 36 months of age who passed the neonatal hearing screening test but are at risk of having sensorineural hearing loss;or

AMBETTER-CP.BH.124 — Attention Deficit Hyperactivity Disorder Assessment and Treatment

AMBETTER-CP.MP.134 — Evoked Potential Testing

ANTHEM-CG-MED-49 — CG-MED-49 Auditory Brainstem Responses (ABRs) and Evoked Otoacoustic Emissions (OAEs) for Hearing Disorders

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