subject: Codes 92543, 92547 allow multiple billings while 92542, 92545 [print this page] Codes 92543, 92547 allow multiple billings while 92542, 92545
With some ENG tests taking one unit while others allowing multiple units, otolaryngology coders have a tough time keeping 92541-92547's billing rules straight. Break down each code and you will be applying the correct number of units to your claims in no time.
Bill 92542 only one time
Even though a positional nystagmus test involves multiple positions, you should code per test, not per position. As CPT's 92542 descriptor states, "Positional nystagmus test, minimum of four positions, with recording" you should never bill 92542 as more than one unit.
Tip: If the test involves fewer than four positions, you may use 92542 with modifier 52 (Reduced services). Positions may include supine with the head extended dorsally, left and right; and sitting.
Report 92543 per Irrigation
However, you may bill multiple units of 92543 (Caloric vestibular test, each irrigation [binaural, bithermal stimulation constitutes four tests], with recording). In this test, the audiologist irrigates the ear with warm and then cold water. If she carries out the irrigation on each side (binaural) with duel temperatures (bithermal), she does four irrigations: right ear - warm, cold; left ear - warm, cold. "Code 92543 is per irrigation, so up to four units is appropriate".
Code single tracking test
When an audiologist carries out an oscillating tracking test (92545, Oscillating tracking test, with recording), you should also limit the units to one. Code 92545 does not really lend itself to multiples.
Here's why? In 92545, the audiologist asks the patient to move only his eyes.
Add-on electrode code per test
You may use multiple units with +92547 (Use of vertical electrodes [list separately in addition to code for primary procedure]). You can bill 92547 up to eight times with 92541-92546. Coding 92547 x 8 shows that the audiologist carries out eight tests that lend themselves to vertical electrode recording.
Why you may hear differently: See to it that your coding guides are up to date.
Five years ago, CPT considered 92547 a per-day code. As the code's descriptor states 'electrodes' plural, prior to 2005, medical coders billed 92547 once per date of service.
For a complete list of ENG codes with unit allowances, stay tuned to a medical coding guide like Supercoder!
