CPT Coding for Balance and/or Vestibular Rehabilitation
What are the Current Procedural Terminology (CPT) codes for balance assessment?
Listed below are the CPT codes used when reporting procedures that are part of a balance system assessment and/or vestibular rehabilitation.
CPT 92541 spontaneous nystagmus test, including gaze and fixation nystagmus, with recording
CPT 92542 positional nystagmus test, minimum of four positions, with recording
CPT 92543 caloric vestibular test, each irrigation (binaural, bithermal, stimulation constitutes four tests), with recording
CPT 92544 optokinetic nystagmus test, bidirectional, foveal or peripheral stimulation, with recording
CPT 92545 oscillating tracking test, with recording
CPT 92546 sinusoidal vertical axis rotational testing
CPT 92547 use of vertical electrodes in any or all of the above tests counts as one additional test
CPT 92548 computerized dynamic posturography
CPT 95992 Canalith repositioning procedure(s) (e.g., Epley maneuver, Semont maneuver), per day. Please note that 95992 is a new code for 2009.
CPT 97112 neuromuscular re-education of movement, balance, coordination, kinesthetic sense, posture, and proprioception
See also: "My Head Is Spinning: An Overview of Reimbursement and Balance Disorders" by Maureen Thompson
Can audiologists bill CPT 92543 for each caloric irrigation performed?
Yes. The CPT descriptor for this code states "per irrigation."
At one time, Medicare in error allowed 92543 to be billed only once even when multiple irrigations were performed. When the relative value was changed to reflect one irrigation the coverage was revised for per irrigation.
Will there be changes in CPT coding for balance procedures in 2009?
Yes. Bob Fifer, Director of Audiology and Speech-Language Pathology at the Mailman Center for Child Development, ASHA advisor to the AMA Relative Value Update Committee, and member of the ASHA Health Care Economics Committee, highlighted some of the 2009 CPT revisions and additions at the 2008 ASHA Convention, Chicago, Illinois. The following information appeared in Presentation 0186, Reimbursement Issues for 2009: Health Care Economics: It's Not Just Coding, It's Your Livelihood [PDF].
- The phrase, "With Observation and Evaluation by Physician" no longer precedes the Vestibular Function Tests Without Electrical Recording codes (92531-92534).
- The phrase, "and Medical Diagnostic Evaluation" no longer precedes the Vestibular Function Tests With Electrical Recording codes (92541-92548). The reference to "PENG" is also deleted.
- The phrase, "With Medical Diagnostic Evaluation" no longer precedes the Audiologic Function Tests (92551-92596).
- A new procedure code in the Other Procedures section of Neurology/Neurology and Neuromuscular Procedures for 2009: 95992 canalith repositioning procedure(s) (e.g., Epley maneuver, Semont maneuver), per day. (Do not report 95992 in conjunction with 92531, 92532.) Please note that audiologists cannot bill Medicare for this procedure because canalith repositioning procedures are not diagnostic tests.