Guidelines

Guideline for Reporting Audiologic Diagnostic Results to DHSS

How to Report

Audiologic reports can be submitted either by direct entry into the DHSS data base or by completing the form that is available online. Please request direct-entry access by contacting the Newborn Hearing Screening Program at: 1-800-877-6246. The form is also available above (Audiologic Diagnostic Form). Complete the form online, then print the form and fax or mail to:

Fax: 573-751-6184

Missouri Department of Health and Senior Services
Newborn Hearing Screening Program
Bureau of Genetics and Healthy Childhood
P.O. Box 570
Jefferson City, MO 65102-0570

 

Who to Report

NOTE: If a child passes the newborn hearing screening and is later diagnosed with a non-permanent conductive hearing loss due to transient middle ear pathology, it is not necessary to submit a report.

 

When to Report

Missouri Regulations 19CSR 40-9.010-40-9.040 require that reports be submitted within 7 days of completion of the diagnostic test.

 

Frequency of Reporting

Once a child is diagnosed with hearing loss, reports for all follow-up exams should be submitted. This is especially important when repeat examination is needed to confirm a diagnosis.

Once behavioral testing commences, a report that includes a pure tone audiogram should be submitted when it is available. If behavioral testing commences, but initial sessions result only in training and no pure tone thresholds are established, it is not necessary to send a report. Audiologists should use discretion about submitting behavioral reports. Reports should be submitted when they contain enough information to confirm the ABR diagnosis or change the ABR. DHSS provides no specific form for submitting behavioral test results. Audiologists should send a copy of the audiogram and report that they typically use to communicate test results.

Once a diagnosis that contains type, degree and laterality of hearing loss for 500 Hz through 8000 Hz has been established by behavioral testing, reports should be submitted annually or sooner if there is a change in hearing status. Annual reports should be submitted for the first 5 years of life.

If a child with hearing loss leaves the service of the audiologist that diagnosed the hearing loss, that audiologist should inform the DHSS that they are no longer seeing this child.

If the child was diagnosed with normal hearing bilaterally, but had a high risk factor for late onset or progressive hearing loss and will have hearing monitors, a report should be submitted at every monitor.

 

What to Report

In addition to ABR diagnostic information, the reporting form requests information on risk factors and recommendations. Audiologists should complete these sections as well as the test results section.

 


 

Guideline for Reporting Hearing Screening Results to DHSS on the Hearing Screening Only Result Form


Repeat hearing screening results performed by hospitals, hearing and speech facilities, primary care physician offices, and home birth centers should be reported on the Hearing Screening Only Result form.

Initial hearing screening results can be submitted on the Hearing Screening Only Result Form when the hearing screening performed by a hospital or birthing center has not been reported on the Initial Hearing Screening Form or through the Missouri Electronic Vital Records (MoEVR) system.

Order Hearing Screening Only Result Forms at no cost from the DHSS warehouse (http://health.mo.gov/warehouse). Or, access the form above (Hearing Screening Only Result Form). Complete the form online, then print the form and fax or mail to:

FAX 573-751-6185

Missouri Department of Health and Senior Services
Newborn Hearing Screening Program
Bureau of Genetics and Healthy Childhood
P.O. Box 570
Jefferson City, MO 65102-0570

 

Who to Report

 

When to Report

Missouri Regulations 19CSR 40-9.010-40-9.040 require that reports be submitted within 7 days of completion of the hearing screening.