Prior authorization request form Form

Otoacoustic Emissions Testing

Last Review Date: April 10, 2026 
Number: MG.MM.ME.33bC3

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Guideline Covered indications for CPT code 92558 (should be used for screening):  Neonatal hearing screening as a preventive service using otoacoustic emissions (OAEs) is proven and/or medically necessary for infants who are 90 days or younger  Evoked OAE is considered medically necessary to screen children 3 years of age and younger who did not have the initial neonatal screening and/or cannot be effectively measured or monitored through audiometry Covered indications for CPT codes 92587 and 92588 (diagnostic evaluations to confirm the presence or absence of hearing disorders):  Infants over 90 days old and children up to 4 years of age
 Children and adults who are or who are unable to cooperate with other methods of hearing testing (e.g., individuals with autism or stroke)
 Children with developmental or delayed speech or language disorders
 Individuals with tinnitus, acoustic trauma, noise induced hearing loss, or sudden hearing loss
 Individuals with auditory neuropathy spectrum disorder (ANSD) or auditory processing disorder (APD)  Individuals with sensorineural hearing loss
 Individuals with abnormal auditory function studies or failed hearing exam
 Individuals who may be feigning a hearing loss
 Monitoring of ototoxicity in individuals before, during, and after administration of agents known to be ototoxic (e.g., aminoglycosides, chemotherapy agents)

Limitations/Exclusions Non-covered indications:  Routine evoked OAE screening (CPT code 92558) at a well-child visit is not considered medically necessary for children 3 years of age and younger who have passed the newborn hearing screen unless the child has a risk factor for hearing loss, has impairment of speech or auditory skills, or has an abnormal middle ear status.
 Comprehensive otoacoustic emissions (CPT code 92588) is considered experimental and investigational for initial screening because there is a lack of evidence of the value of comprehensive testing over the limited otoacoustic emissions for this indication.  Auditory screening or diagnostic testing using otoacoustic emissions (OAEs) is unproven and/or not medically necessary for all other populations and conditions other than those listed as a covered indication

Clinical Background Otoacoustic emissions testing evaluates the integrity of the inner ear (cochlea). In response to noise, vibrations of the hair cells in a healthy inner ear generate electrical responses, known as otoacoustic emissions. The absence of OAEs indicates that the inner ear is not responding appropriately to sound. Transient evoked otoacoustic emissions (TEOAEs) are generated in response to wide-band clicks, while distortion product otoacoustic emissions (DPOAE) are a response to tones. Both stimuli are presented via a light-weight ear canal probe. A microphone picks up the signal, and multiple responses are averaged to get a specific repeatable waveform. Otoacoustic emissions are used in screening and diagnosis of hearing impairments in infants, and in young children and patients with cognitive impairments (e.g., mental retardation, dementia) who are unable to respond reliably to standard hearing tests. Otoacoustic emissions are also useful for evaluating patients with tinnitus, suspected malingering, and for monitoring cochlear damage from ototoxic drugs. Auditory screening or diagnostic testing using otoacoustic emissions (OAEs) is unproven and/or not medically necessary for all other populations and conditions other than those listed as proven and medically necessary. There is inadequate evidence that hearing screening with OAEs is superior to screening audiometry in improving health outcomes such as timely facilitation of speech, language, and communication skills in older children or adults. There is also inadequate evidence to indicate that the use of diagnostic otoacoustic emissions (OAEs) testing is superior to screening audiometry in improving health outcomes such as timely facilitation of speech, language, and communication skills in individuals with other conditions other than those indicated as proven and medically necessary. Professional Societies and Guidelines U.S. Preventive Services Task Force (USPSTF)
The USPSTF recommends that newborn hearing screening programs include (USPSTF, 2014):  A one-step or two-step validated protocol which frequently involves otoacoustic emissions (OAEs) followed by auditory brainstem response (ABR) in those who failed the first test;
 Protocols to ensure that infants with positive screening-test results receive appropriate audiologic evaluation and follow-up after discharge;
 Screening and follow-up should be in place for newborns delivered at home, birthing centers, or hospitals without hearing screening facilities; and
 Hearing screening before one month of age. Those infants who do not pass the newborn screening should undergo audiologic and medical evaluation before 3 months of age American Academy of Pediatrics (AAP) In February 1999, the American Academy of Pediatrics endorsed the implementation of universal newborn hearing screening. (AAP, 1999) In a clinical report for hearing assessment in infants and children, the AAP states that ABR and OAEs are tests of auditory pathway structural integrity but are not true tests of hearing. Even if ABR or OAE test results are normal, hearing cannot be definitively considered normal until a child is mature enough for a reliable behavioral audiogram to be obtained. Behavioral pure-tone audiometry remains the standard for hearing evaluation. According to the AAP, a failed infant

hearing screening or a failed screening in an older child should always be confirmed by further testing. Audiologists may repeat the audiometric tests in a sound booth and using a variety of other tests. ABR can also be used for definitive testing of the auditory system. Diagnostic ABR is often the definitive test used by audiologists in children and infants who are unable to cooperate with other methods of hearing testing. A diagnostic ABR is usually performed under sedation or general anesthesia in children aged approximately 3 to 6 months and older. Diagnostic ABR provides information that is accurate enough to allow for therapeutic intervention. According to the AAP, the OAE test also does not assess the integrity of the neural transmission of sound from the eighth nerve to the brainstem and, therefore, will miss auditory neuropathy and other neuronal abnormalities. Infants with such abnormalities will have normal OAE test results but abnormal auditory brainstem response (ABR) test results. A failed OAE test only implies that a hearing loss of more than 30 to 40 dB may exist or that the middle-ear status is abnormal (Harlor, 2009). In a policy statement for the pediatrician's role in the diagnosis and management of autistic spectrum disorder in children, the AAP states that any child who has language delays should be referred for an audiologic and a comprehensive speech and language evaluation. If the child is uncooperative, diagnostic otoacoustic emissions or sedated brainstem auditory evoked responses should be obtained. (AAP, 2001) American Academy of Audiology (AAA)
The American Academy of Audiology (AAO, 2011) endorses the detection of hearing disorders in early childhood and school‐aged populations using evidence‐based hearing screening methods. OAEs are recommended for preschool and school age children for whom pure tone screening is not developmentally appropriate (ability levels less than 3 years). Revision History Apr. 14, 2023 Individuals with “abnormal auditory perception” changed to “auditory neuropathy spectrum disorder (ANSD) or auditory processing disorder (APD)” Apr. 12, 2019 Content changes eff. Jul. 15, 2019  Changed title from Otoacoustic Emission Testing for Pediatric Populations in the Primary Care Setting to Otoacoustic Emissions Testing.
 Added diagnostic indications.  Qualified that routine evoked OAE screening at a well-child visit is not considered medically necessary for children 3 years of age and younger who have passed the newborn hearing screen unless specified clinical indicators are present.  Added that comprehensive auditory evoked response testing and comprehensive otoacoustic emissions are considered experimental and investigational. Nov. 1, 2011 Inception date.

Applicable Procedure Codes 92558 Evoked otoacoustic emissions, screening (qualitative measurement of distortion product or transient evoked otoacoustic emissions), automated analysis 92587
Distortion product evoked otoacoustic emissions; limited evaluation (to confirm the presence or absence of hearing disorder, 3-6 frequencies) or transient evoked otoacoustic emissions, with interpretation and report 92588
Distortion product evoked otoacoustic emissions; comprehensive diagnostic evaluation (quantitative analysis of outer hair cell function by cochlear mapping, minimum of 12 frequencies), with interpretation and report

Applicable ICD-10 Diagnosis Codes A17.0 Tuberculous meningitis

A39.0 Meningococcal meningitis A52.13 Late syphilitic meningitis A80.0 Acute paralytic poliomyelitis, vaccine-associated A80.1 Acute paralytic poliomyelitis, wild virus, imported A80.2 Acute paralytic poliomyelitis, wild virus, indigenous A80.30 Acute paralytic poliomyelitis, unspecified A80.39 Other acute paralytic poliomyelitis A80.9 Acute poliomyelitis, unspecified A87.0 Enteroviral meningitis A87.8 Other viral meningitis A87.9 Viral meningitis, unspecified B02.1 Zoster meningitis B26.1 Mumps meningitis B45.1 Cerebral cryptococcosis B83.2 Angiostrongyliasis due to Parastrongylus cantonensis B91 Sequelae of poliomyelitis F01.50 Vascular dementia without behavioral disturbance F01.51 Vascular dementia with behavioral disturbance F02.80 Dementia in other diseases classified elsewhere without behavioral disturbance F02.81 Dementia in other diseases classified elsewhere with behavioral disturbance F03.90 Unspecified dementia without behavioral disturbance F03.91 Unspecified dementia with behavioral disturbance F07.9 Unspecified personality and behavioral disorder due to known physiological condition F09 Unspecified mental disorder due to known physiological condition F44.6 Conversion disorder with sensory symptom or deficit
F45.8 Other somatoform disorders F68.10 Factitious disorder, unspecified
F68.12 Factitious disorder with predominantly physical signs and symptoms
F68.13 Factitious disorder with combined psychological and physical signs and symptoms
F71 Moderate intellectual disabilities F72 Severe intellectual disabilities F73 Profound intellectual disabilities F78 Other intellectual disabilities F79 Unspecified intellectual disabilities F80.1 Expressive language disorder F80.2 Mixed receptive-expressive language disorder F80.4 Speech and language development delay due to hearing loss F80.82 Social pragmatic communication disorder F80.9 Developmental disorder of speech and language, unspecified F84.0 Autistic disorder

F84.2 Rett's syndrome
F84.2 Rett’s syndrome
F84.3 Other childhood disintegrative disorder F84.5 Asperger's syndrome F84.8 Other pervasive developmental disorders F84.9 Pervasive developmental disorder, unspecified F90.1 Attention-deficit hyperactivity disorder, predominantly hyperactive type F90.2 Attention-deficit hyperactivity disorder, combined type F90.8 Attention-deficit hyperactivity disorder, other type F95.2 Tourette's disorder G00.0 Hemophilus meningitis G00.1 Pneumococcal meningitis G00.2 Streptococcal meningitis G00.3 Staphylococcal meningitis G00.8 Other bacterial meningitis G00.9 Bacterial meningitis, unspecified G01 Meningitis in bacterial diseases classified elsewhere G02 Meningitis in other infectious and parasitic diseases classified elsewhere G03.0 Nonpyogenic meningitis G03.1 Chronic meningitis G03.2 Benign recurrent meningitis [Mollaret] G03.8 Meningitis due to other specified causes G03.9 Meningitis, unspecified G04.2 Bacterial meningoencephalitis and meningomyelitis, not elsewhere classified G20 Parkinson's disease G21.0 Malignant neuroleptic syndrome G21.3 Postencephalitic parkinsonism G21.4 Vascular parkinsonism G21.8 Other secondary parkinsonism G21.9 Secondary parkinsonism, unspecified G21.11 Neuroleptic induced parkinsonism G23.0 Hallervorden-Spatz disease G23.1 Progressive supranuclear ophthalmoplegia [Steele-Richardson-Olszewski] G23.2 Striatonigral degeneration G23.8 Other specified degenerative diseases of basal ganglia G23.9 Degenerative disease of basal ganglia, unspecified G30.0 Alzheimer's disease with early onset G30.1 Alzheimer's disease with late onset G30.8 Other Alzheimer's disease G30.9 Alzheimer's disease, unspecified

G46.3 Brain stem stroke syndrome G46.4 Cerebellar stroke syndrome G46.5 Pure motor lacunar syndrome G46.6 Pure sensory lacunar syndrome G46.7 Other lacunar syndromes G46.8 Other vascular syndromes of brain in cerebrovascular diseases G52.7 Disorders of multiple cranial nerves G60.8 Other hereditary and idiopathic neuropathies G72.3 Periodic paralysis G80.0 Spastic quadriplegic cerebral palsy G80.1 Spastic diplegic cerebral palsy G80.2 Spastic hemiplegic cerebral palsy G80.3 Athetoid cerebral palsy G80.4 Ataxic cerebral palsy G80.8 Other cerebral palsy G80.9 Cerebral palsy, unspecified G83.81 Brown-Sequard syndrome G83.82 Anterior cord syndrome G83.83 Posterior cord syndrome G83.84 Todd's paralysis (postepileptic) G83.89 Other specified paralytic syndromes G83.9 Paralytic syndrome, unspecified G90.09 Other idiopathic peripheral autonomic neuropathy G90.3 Multi-system degeneration of the autonomic nervous system G93.1 Anoxic brain damage, not elsewhere classified H83.01 Labyrinthitis, right ear H83.02 Labyrinthitis, left ear H83.03 Labyrinthitis, bilateral H83.09 Labyrinthitis, unspecified ear H83.3X1 Noise effects on right inner ear H83.3X2 Noise effects on left inner ear H83.3X3 Noise effects on inner ear, bilateral H83.3X9 Noise effects on inner ear, unspecified ear H90.3 Sensorineural hearing loss, bilateral H90.41 Sensorineural hearing loss, unilateral, right ear, with unrestricted hearing on the contralateral side H90.42 Sensorineural hearing loss, unilateral, left ear, with unrestricted hearing on the contralateral side H90.5 Unspecified sensorineural hearing loss H90.6 Mixed conductive and sensorineural hearing loss, bilateral H90.71 Mixed conductive and sensorineural hearing loss, unilateral, right ear, with unrestricted hearing on the contralateral side H90.72 Mixed conductive and sensorineural hearing loss, unilateral, left ear, with unrestricted hearing on the contralateral side

H90.8 Mixed conductive and sensorineural hearing loss, unspecified H90.A11 Conductive hearing loss, unilateral, right ear with restricted hearing on the contralateral side H90.A12 Conductive hearing loss, unilateral, left ear with restricted hearing on the contralateral side H90.A21 Sensorineural hearing loss, unilateral, right ear, with restricted hearing on the contralateral side H90.A22 Sensorineural hearing loss, unilateral, left ear, with restricted hearing on the contralateral side H90.A31 Mixed conductive and sensorineural hearing loss, unilateral, right ear with restricted hearing on the contralateral side H90.A32 Mixed conductive and sensorineural hearing loss, unilateral, left ear with restricted hearing on the contralateral side H91.01 Ototoxic hearing loss, right ear H91.02 Ototoxic hearing loss, left ear H91.03 Ototoxic hearing loss, bilateral H91.09 Ototoxic hearing loss, unspecified ear H91.20 Sudden idiopathic hearing loss, unspecified ear H91.21 Sudden idiopathic hearing loss, right ear H91.22 Sudden idiopathic hearing loss, left ear H91.23 Sudden idiopathic hearing loss, bilateral H91.8X1 Other specified hearing loss, right ear H91.8X2 Other specified hearing loss, left ear H91.8X3 Other specified hearing loss, bilateral H91.8X9 Other specified hearing loss, unspecified ear H93.011 Transient ischemic deafness, right ear H93.012 Transient ischemic deafness, left ear H93.013 Transient ischemic deafness, bilateral H93.019 Transient ischemic deafness, unspecified ear H93.11 Tinnitus, right ear H93.12 Tinnitus, left ear H93.13 Tinnitus, bilateral H93.19 Tinnitus, unspecified ear H93.211 Auditory recruitment, right ear H93.212 Auditory recruitment, left ear H93.213 Auditory recruitment, bilateral H93.219 Auditory recruitment, unspecified ear H93.221 Diplacusis, right ear H93.222 Diplacusis, left ear H93.223 Diplacusis, bilateral H93.229 Diplacusis, unspecified ear H93.231 Hyperacusis, right ear H93.232 Hyperacusis, left ear H93.233 Hyperacusis, bilateral H93.239 Hyperacusis, unspecified ear H93.241 Temporary auditory threshold shift, right ear

H93.242 Temporary auditory threshold shift, left ear H93.243 Temporary auditory threshold shift, bilateral H93.249 Temporary auditory threshold shift, unspecified ear H93.25 Central auditory processing disorder H93.291 Other abnormal auditory perceptions, right ear H93.292 Other abnormal auditory perceptions, left ear H93.293 Other abnormal auditory perceptions, bilateral H93.299 Other abnormal auditory perceptions, unspecified ear H93.A1 Pulsatile tinnitus, right ear H93.A2 Pulsatile tinnitus, left ear H93.A3 Pulsatile tinnitus, bilateral H93.A9 Pulsatile tinnitus, unspecified ear I67.2 Cerebral atherosclerosis I67.81 Acute cerebrovascular insufficiency I67.82 Cerebral ischemia I67.850 Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy I67.89 Other cerebrovascular disease I68.0 Cerebral amyloid angiopathy I68.8 Other cerebrovascular disorders in diseases classified elsewhere I69.00 Unspecified sequelae of nontraumatic subarachnoid hemorrhage I69.010 Attention and concentration deficit following nontraumatic subarachnoid hemorrhage I69.011 Memory deficit following nontraumatic subarachnoid hemorrhage I69.012 Visuospatial deficit and spatial neglect following nontraumatic subarachnoid hemorrhage I69.013 Psychomotor deficit following nontraumatic subarachnoid hemorrhage I69.014 Frontal lobe and executive function deficit following nontraumatic subarachnoid hemorrhage I69.015 Cognitive social or emotional deficit following nontraumatic subarachnoid hemorrhage I69.018 Other symptoms and signs involving cognitive functions following nontraumatic subarachnoid hemorrhage I69.019 Unspecified symptoms and signs involving cognitive functions following nontraumatic subarachnoid hemorrhage I69.020 Aphasia following nontraumatic subarachnoid hemorrhage I69.021 Dysphasia following nontraumatic subarachnoid hemorrhage I69.022 Dysarthria following nontraumatic subarachnoid hemorrhage I69.023 Fluency disorder following nontraumatic subarachnoid hemorrhage I69.028 Other speech and language deficits following nontraumatic subarachnoid hemorrhage I69.090 Apraxia following nontraumatic subarachnoid hemorrhage I69.091 Dysphagia following nontraumatic subarachnoid hemorrhage I69.092 Facial weakness following nontraumatic subarachnoid hemorrhage I69.093 Ataxia following nontraumatic subarachnoid hemorrhage I69.098 Other sequelae following nontraumatic subarachnoid hemorrhage I69.10 Unspecified sequelae of nontraumatic intracerebral hemorrhage I69.110 Attention and concentration deficit following nontraumatic intracerebral hemorrhage

I69.111 Memory deficit following nontraumatic intracerebral hemorrhage I69.112 Visuospatial deficit and spatial neglect following nontraumatic intracerebral hemorrhage I69.113 Psychomotor deficit following nontraumatic intracerebral hemorrhage I69.114 Frontal lobe and executive function deficit following nontraumatic intracerebral hemorrhage I69.115 Cognitive social or emotional deficit following nontraumatic intracerebral hemorrhage I69.118 Other symptoms and signs involving cognitive functions following nontraumatic intracerebral hemorrhage I69.119 Unspecified symptoms and signs involving cognitive functions following nontraumatic intracerebral hemorrhage I69.120 Aphasia following nontraumatic intracerebral hemorrhage I69.121 Dysphasia following nontraumatic intracerebral hemorrhage I69.122 Dysarthria following nontraumatic intracerebral hemorrhage I69.123 Fluency disorder following nontraumatic intracerebral hemorrhage I69.128 Other speech and language deficits following nontraumatic intracerebral hemorrhage I69.190 Apraxia following nontraumatic intracerebral hemorrhage I69.191 Dysphagia following nontraumatic intracerebral hemorrhage I69.192 Facial weakness following nontraumatic intracerebral hemorrhage I69.193 Ataxia following nontraumatic intracerebral hemorrhage I69.198 Other sequelae of nontraumatic intracerebral hemorrhage I69.20 Unspecified sequelae of other nontraumatic intracranial hemorrhage I69.210 Attention and concentration deficit following other nontraumatic intracranial hemorrhage I69.211 Memory deficit following other nontraumatic intracranial hemorrhage I69.212 Visuospatial deficit and spatial neglect following other nontraumatic intracranial hemorrhage I69.213 Psychomotor deficit following other nontraumatic intracranial hemorrhage I69.214 Frontal lobe and executive function deficit following other nontraumatic intracranial hemorrhage I69.215 Cognitive social or emotional deficit following other nontraumatic intracranial hemorrhage I69.218 Other symptoms and signs involving cognitive functions following other nontraumatic intracranial hemorrhage I69.219 Unspecified symptoms and signs involving cognitive functions following other nontraumatic intracranial hemorrhage I69.220 Aphasia following other nontraumatic intracranial hemorrhage I69.221 Dysphasia following other nontraumatic intracranial hemorrhage I69.222 Dysarthria following other nontraumatic intracranial hemorrhage I69.223 Fluency disorder following other nontraumatic intracranial hemorrhage I69.228 Other speech and language deficits following other nontraumatic intracranial hemorrhage I69.290 Apraxia following other nontraumatic intracranial hemorrhage I69.291 Dysphagia following other nontraumatic intracranial hemorrhage I69.292 Facial weakness following other nontraumatic intracranial hemorrhage I69.293 Ataxia following other nontraumatic intracranial hemorrhage I69.298 Other sequelae of other nontraumatic intracranial hemorrhage I69.30 Unspecified sequelae of cerebral infarction I69.310 Attention and concentration deficit following cerebral infarction I69.311 Memory deficit following cerebral infarction I69.312 Visuospatial deficit and spatial neglect following cerebral infarction

I69.313 Psychomotor deficit following cerebral infarction I69.314 Frontal lobe and executive function deficit following cerebral infarction I69.315 Cognitive social or emotional deficit following cerebral infarction I69.318 Other symptoms and signs involving cognitive functions following cerebral infarction I69.319 Unspecified symptoms and signs involving cognitive functions following cerebral infarction I69.320 Aphasia following cerebral infarction I69.321 Dysphasia following cerebral infarction I69.322 Dysarthria following cerebral infarction I69.323 Fluency disorder following cerebral infarction I69.328 Other speech and language deficits following cerebral infarction I69.390 Apraxia following cerebral infarction I69.391 Dysphagia following cerebral infarction I69.392 Facial weakness following cerebral infarction I69.393 Ataxia following cerebral infarction I69.398 Other sequelae of cerebral infarction I69.80 Unspecified sequelae of other cerebrovascular disease I69.810 Attention and concentration deficit following other cerebrovascular disease I69.811 Memory deficit following other cerebrovascular disease I69.812 Visuospatial deficit and spatial neglect following other cerebrovascular disease I69.813 Psychomotor deficit following other cerebrovascular disease I69.814 Frontal lobe and executive function deficit following other cerebrovascular disease I69.815 Cognitive social or emotional deficit following other cerebrovascular disease I69.818 Other symptoms and signs involving cognitive functions following other cerebrovascular disease I69.819 Unspecified symptoms and signs involving cognitive functions following other cerebrovascular disease I69.820 Aphasia following other cerebrovascular disease I69.821 Dysphasia following other cerebrovascular disease I69.822 Dysarthria following other cerebrovascular disease I69.823 Fluency disorder following other cerebrovascular disease I69.828 Other speech and language deficits following other cerebrovascular disease I69.890 Apraxia following other cerebrovascular disease I69.891 Dysphagia following other cerebrovascular disease I69.892 Facial weakness following other cerebrovascular disease I69.893 Ataxia following other cerebrovascular disease I69.898 Other sequelae of other cerebrovascular disease I69.90 Unspecified sequelae of unspecified cerebrovascular disease I69.910 Attention and concentration deficit following unspecified cerebrovascular disease I69.911 Memory deficit following unspecified cerebrovascular disease I69.912 Visuospatial deficit and spatial neglect following unspecified cerebrovascular disease I69.913 Psychomotor deficit following unspecified cerebrovascular disease I69.914 Frontal lobe and executive function deficit following unspecified cerebrovascular disease

I69.915 Cognitive social or emotional deficit following unspecified cerebrovascular disease I69.918 Other symptoms and signs involving cognitive functions following unspecified cerebrovascular disease I69.919 Unspecified symptoms and signs involving cognitive functions following unspecified cerebrovascular disease I69.920 Aphasia following unspecified cerebrovascular disease I69.921 Dysphasia following unspecified cerebrovascular disease I69.922 Dysarthria following unspecified cerebrovascular disease I69.923 Fluency disorder following unspecified cerebrovascular disease I69.928 Other speech and language deficits following unspecified cerebrovascular disease I69.990 Apraxia following unspecified cerebrovascular disease I69.991 Dysphagia following unspecified cerebrovascular disease I69.992 Facial weakness following unspecified cerebrovascular disease I69.993 Ataxia following unspecified cerebrovascular disease I69.998 Other sequelae following unspecified cerebrovascular disease I97.810 Intraoperative cerebrovascular infarction during cardiac surgery I97.811 Intraoperative cerebrovascular infarction during other surgery I97.820 Postprocedural cerebrovascular infarction following cardiac surgery I97.821 Postprocedural cerebrovascular infarction following other surgery P11.1 Other specified brain damage due to birth injury P11.2 Unspecified brain damage due to birth injury Q90.0 Trisomy 21, nonmosaicism (meiotic nondisjunction) Q90.1 Trisomy 21, mosaicism (mitotic nondisjunction) Q90.2 Trisomy 21, translocation Q90.9 Down syndrome, unspecified R29.5 Transient paralysis R41.89 Other symptoms and signs involving cognitive functions and awareness R42 Dizziness and giddiness R47.01 Aphasia R47.02 Dysphasia R47.1 Dysarthria and anarthria R49.1 Aphonia R62.0 Delayed milestone in childhood R94.120 Abnormal auditory function study R94.121 Abnormal vestibular function study R94.128 Abnormal results of other function studies of ear and other special senses S09.20XA Traumatic rupture of unspecified ear drum, initial encounter S09.21XA Traumatic rupture of right ear drum, initial encounter S09.22XA Traumatic rupture of left ear drum, initial encounter S09.311A Abnormal results of other function studies of ear and other special senses S09.312A Primary blast injury of left ear, initial encounter S09.313A Primary blast injury of ear, bilateral, initial encounter

S09.319A Primary blast injury of unspecified ear, initial encounter S12.000A Unspecified displaced fracture of first cervical vertebra, initial encounter for closed fracture S12.000B Unspecified displaced fracture of first cervical vertebra, initial encounter for open fracture S12.001A Unspecified nondisplaced fracture of first cervical vertebra, initial encounter for closed fracture S12.001B Unspecified nondisplaced fracture of first cervical vertebra, initial encounter for open fracture S12.100A Unspecified displaced fracture of second cervical vertebra, initial encounter for closed fracture S12.100B Unspecified displaced fracture of second cervical vertebra, initial encounter for open fracture S12.101A Unspecified nondisplaced fracture of second cervical vertebra, initial encounter for closed fracture S12.101B Unspecified nondisplaced fracture of second cervical vertebra, initial encounter for open fracture S12.200A Unspecified displaced fracture of third cervical vertebra, initial encounter for closed fracture S12.200B Unspecified displaced fracture of third cervical vertebra, initial encounter for open fracture S12.201A Unspecified nondisplaced fracture of third cervical vertebra, initial encounter for closed fracture S12.201B Unspecified nondisplaced fracture of third cervical vertebra, initial encounter for open fracture S12.300A Unspecified displaced fracture of fourth cervical vertebra, initial encounter for closed fracture S12.300B Unspecified displaced fracture of fourth cervical vertebra, initial encounter for open fracture S12.301A Unspecified nondisplaced fracture of fourth cervical vertebra, initial encounter for closed fracture S12.301B Unspecified nondisplaced fracture of fourth cervical vertebra, initial encounter for open fracture S12.400A Unspecified displaced fracture of fifth cervical vertebra, initial encounter for closed fracture S12.400B Unspecified displaced fracture of fifth cervical vertebra, initial encounter for open fracture S12.401A Unspecified nondisplaced fracture of fifth cervical vertebra, initial encounter for closed fracture S12.401B Unspecified nondisplaced fracture of fifth cervical vertebra, initial encounter for open fracture S12.500A Unspecified displaced fracture of sixth cervical vertebra, initial encounter for closed fracture S12.500B Unspecified displaced fracture of sixth cervical vertebra, initial encounter for open fracture S12.501A Unspecified nondisplaced fracture of sixth cervical vertebra, initial encounter for closed fracture S12.501B Unspecified nondisplaced fracture of sixth cervical vertebra, initial encounter for open fracture S12.600A Unspecified displaced fracture of seventh cervical vertebra, initial encounter for closed fracture S12.600B Unspecified displaced fracture of seventh cervical vertebra, initial encounter for open fracture S12.601A Unspecified nondisplaced fracture of seventh cervical vertebra, initial encounter for closed fracture S12.601B Unspecified nondisplaced fracture of seventh cervical vertebra, initial encounter for open fracture S14.101A Unspecified injury at C1 level of cervical spinal cord, initial encounter S14.102A Unspecified injury at C2 level of cervical spinal cord, initial encounter S14.103A Unspecified injury at C3 level of cervical spinal cord, initial encounter S14.104A Unspecified injury at C4 level of cervical spinal cord, initial encounter S14.105A Unspecified injury at C5 level of cervical spinal cord, initial encounter S14.106A Unspecified injury at C6 level of cervical spinal cord, initial encounter S14.107A Unspecified injury at C7 level of cervical spinal cord, initial encounter S14.111A Complete lesion at C1 level of cervical spinal cord, initial encounter S14.112A Complete lesion at C2 level of cervical spinal cord, initial encounter S14.113A Complete lesion at C3 level of cervical spinal cord, initial encounter S14.114A Complete lesion at C4 level of cervical spinal cord, initial encounter

S14.115A Complete lesion at C5 level of cervical spinal cord, initial encounter S14.116A Complete lesion at C6 level of cervical spinal cord, initial encounter S14.117A Complete lesion at C7 level of cervical spinal cord, initial encounter S14.121A Central cord syndrome at C1 level of cervical spinal cord, initial encounter S14.122A Central cord syndrome at C2 level of cervical spinal cord, initial encounter S14.123A Central cord syndrome at C3 level of cervical spinal cord, initial encounter S14.124A Central cord syndrome at C4 level of cervical spinal cord, initial encounter S14.125A Central cord syndrome at C5 level of cervical spinal cord, initial encounter S14.126A Central cord syndrome at C6 level of cervical spinal cord, initial encounter S14.127A Central cord syndrome at C7 level of cervical spinal cord, initial encounter S14.131A Anterior cord syndrome at C1 level of cervical spinal cord, initial encounter S14.132A Anterior cord syndrome at C2 level of cervical spinal cord, initial encounter S14.133A Anterior cord syndrome at C3 level of cervical spinal cord, initial encounter S14.134A Anterior cord syndrome at C4 level of cervical spinal cord, initial encounter S14.135A Anterior cord syndrome at C5 level of cervical spinal cord, initial encounter S14.136A Anterior cord syndrome at C6 level of cervical spinal cord, initial encounter S14.137A Anterior cord syndrome at C7 level of cervical spinal cord, initial encounter S14.151A Other incomplete lesion at C1 level of cervical spinal cord, initial encounter S14.152A Other incomplete lesion at C2 level of cervical spinal cord, initial encounter S14.153A Other incomplete lesion at C3 level of cervical spinal cord, initial encounter S14.154A Other incomplete lesion at C4 level of cervical spinal cord, initial encounter S14.155A Other incomplete lesion at C5 level of cervical spinal cord, initial encounter S14.156A Other incomplete lesion at C6 level of cervical spinal cord, initial encounter S14.157A Other incomplete lesion at C7 level of cervical spinal cord, initial encounter T20.011S Burn of unspecified degree of right ear [any part, except ear drum], sequela T20.012S Burn of unspecified degree of left ear [any part, except ear drum], sequela T20.111S Burn of first degree of right ear [any part, except ear drum], sequela T20.112S Burn of first degree of left ear [any part, except ear drum], sequela T20.119S Burn of first degree of unspecified ear [any part, except ear drum], sequela T20.211S Burn of second degree of right ear [any part, except ear drum], sequela T20.212S Burn of second degree of left ear [any part, except ear drum], sequela T20.219S Burn of second degree of unspecified ear [any part, except ear drum], sequela T20.311S Burn of third degree of right ear [any part, except ear drum], sequela T20.312S Burn of third degree of left ear [any part, except ear drum], sequela T20.319S Burn of third degree of unspecified ear [any part, except ear drum], sequela T20.411S Corrosion of unspecified degree of right ear [any part, except ear drum], sequela T20.412S Corrosion of unspecified degree of left ear [any part, except ear drum], sequela T20.419S Corrosion of unspecified degree of unspecified ear [any part, except ear drum], sequela T20.511S Corrosion of first degree of right ear [any part, except ear drum], sequela T20.512S Corrosion of first degree of left ear [any part, except ear drum], sequela

T20.519S Corrosion of first degree of unspecified ear [any part, except ear drum], sequela T20.611S Corrosion of second degree of right ear [any part, except ear drum], sequela T20.612S Corrosion of second degree of left ear [any part, except ear drum], sequela T20.619S Corrosion of second degree of unspecified ear [any part, except ear drum], sequela T20.711S Corrosion of third degree of right ear [any part, except ear drum], sequela T20.712S Corrosion of third degree of left ear [any part, except ear drum], sequela T20.719S Corrosion of third degree of unspecified ear [any part, except ear drum], sequela T28.411S Burn of right ear drum, sequela T28.412S Burn of left ear drum, sequela T28.419S Burn of unspecified ear drum, sequela T28.911S Corrosions of right ear drum, sequela T28.912S Corrosions of left ear drum, sequela T28.919S Corrosions of unspecified ear drum, sequela T36.5X1A Poisoning by aminoglycosides, accidental (unintentional), initial encounter T36.5X1D Poisoning by aminoglycosides, accidental (unintentional), subsequent encounter T36.5X1S Poisoning by aminoglycosides, accidental (unintentional), sequela T36.5X2A Poisoning by aminoglycosides, intentional self-harm, initial encounter T36.5X2D Poisoning by aminoglycosides, intentional self-harm, subsequent encounter T36.5X2S Poisoning by aminoglycosides, intentional self-harm, sequela T36.5X3A Poisoning by aminoglycosides, assault, initial encounter T36.5X3D Poisoning by aminoglycosides, assault, subsequent encounter T36.5X3S Poisoning by aminoglycosides, assault, sequela T36.5X4A Poisoning by aminoglycosides, undetermined, initial encounter T36.5X4D Poisoning by aminoglycosides, undetermined, subsequent encounter T36.5X4S Poisoning by aminoglycosides, undetermined, sequela T36.5X5A Adverse effect of aminoglycosides, initial encounter T36.5X5D Adverse effect of aminoglycosides, subsequent encounter T36.5X5S Adverse effect of aminoglycosides, sequela T36.6X1A Poisoning by rifampicins, accidental (unintentional), initial encounter T36.6X2A Poisoning by rifampicins, intentional self-harm, initial encounter T36.6X3A Poisoning by rifampicins, assault, initial encounter T36.6X4A Poisoning by rifampicins, undetermined, initial encounter T36.6X5A Adverse effect of rifampicins, initial encounter T36.8X1A Poisoning by other systemic antibiotics, accidental (unintentional), initial encounter T36.8X2A Poisoning by other systemic antibiotics, intentional self-harm, initial encounter T36.8X3A Poisoning by other systemic antibiotics, assault, initial encounter T36.8X4A Poisoning by other systemic antibiotics, undetermined, initial encounter T36.8X5A Adverse effect of other systemic antibiotics, initial encounter T45.1X1A Poisoning by antineoplastic and immunosuppressive drugs, accidental (unintentional), initial encounter T45.1X2A Poisoning by antineoplastic and immunosuppressive drugs, intentional self-harm, initial encounter

T45.1X3A Poisoning by antineoplastic and immunosuppressive drugs, assault, initial encounter T45.1X4A Poisoning by antineoplastic and immunosuppressive drugs, undetermined, initial encounter T45.1X5A Adverse effect of antineoplastic and immunosuppressive drugs, initial encounter T79.8XXA Other early complications of trauma, initial encounter Z01.110 Encounter for hearing examination following failed hearing screening Z01.118 Encounter for examination of ears and hearing with other abnormal findings Z13.40 Encounter for screening for unspecified developmental delays Z13.41 Encounter for autism screening Z13.42 Encounter for screening for global developmental delays (milestones) Z13.49 Encounter for screening for other developmental delays Z13.5 Encounter for screening for eye and ear disorders Z57.0 Occupational exposure to noise Z76.5 Malingerer [conscious simulation] Z77.122 Contact with and (suspected) exposure to noise Z87.820 Personal history of traumatic brain injury Z92.21 Personal history of antineoplastic chemotherapy References American Academy of Audiology Childhood Hearing Screening Guidelines (2011). Available at: http://www.cdc.gov/ncbddd/hearingloss/documents/AAA_Childhood%20Hearing%20Guidelines_2011.pdf. Accessed April 14, 2026. American Academy of Audiology. Position Statement and Clinical Practice Guidelines: Ototoxicity Monitoring. October 2009. Available at: https://audiology-web.s3.amazonaws.com/migrated/OtoMonGuidelines.pdf_539974c40999c1.58842217.pdf. Accessed April 14, 2026. American Academy of Pediatrics. Newborn and Infant hearing loss: Detection and Intervention (RE9846). Pediatrics. 1999; 103:527-530.
American Academy of Pediatrics. The Pediatrician's Role in the Diagnosis and Management of Autistic Spectrum Disorder in Children 2001. Available at: https://publications.aap.org/pediatrics/article-abstract/107/5/1221/66186/The-Pediatrician-s-Role-in-the-Diagnosis- and?redirectedFrom=fulltext. Accessed April 14, 2026. American Academy of Pediatrics/American Academy of Audiology/Joint Committee on Infant Hearing. Year 2007 Position Statement: Principles and Guidelines for Early Hearing Detection and Intervention Programs (Joint Committee on Infant Hearing). Pediatrics. 2007;120;898-921 (doi:10.1542/peds.2007-2333). Available at: https://www.cdc.gov/ncbddd/hearingloss/documents/jcih_2007.pdf. Accessed April 14, 2026. Centers for Disease Control and Prevention, National Center on Birth Defects and Developmental Disabilities. Hearing Loss in Children; Screening and Diagnosis. Last updated September 28, 2016. Available at: https://www.cdc.gov/NCBDDD/hearingloss/screening.html. Accessed April 14, 2026. Joint Committee on Infant Hearing (JCIH): American Academy of Audiology/American Academy of Pediatrics/(AAP)/ American Speech- Language-Hearing Association/Directors of Speech and Hearing Programs in State Health and Welfare Agencies: Year 2007 Position Statement Principles and Guidelines for Early Hearing Detection and Intervention Programs published online October 1, 2007 in Pediatrics Vol. 120 No. 4 October 2007, pp. 898-921 (doi:10.1542/peds.2007-2333). Specialty-matched clinical peer review.