CPT for ENT: Vertical Electrodes

CPT for ENT: Vertical Electrodes

Q: How do you code for the use of verticalelectrodes in vestibular function tests?(CPT Code +92547: use of vertical electrodes (List separately in addition to code for primaryprocedure)
 
A: On February 1, 2005, new guidelines became available to report this CPT code. Previously,the AMA CPT Assistant advised that add-on code+92547 should be reported once per day,regardless of the number of vestibular function tests performed (CPT codes 92541-92546) and/or the number of electrodes placed.

The AMA CPT Coding Assistant recommends the appropriateness of reporting CPT code +92547multiple times per day, based on the number of primary procedures performed. The number of units billed with +92547 should reflect the number of vestibular function test performed during the encounter.

Example of CMS 1500 Claim Form data for which vertical electrodes were used with all tests in the battery:

DOS
POS
EMG
CPT/HCPCS
MOD DX CHARGE UNITS
2/1/2009
11
 
92541
51 386   1
2/2/2009
11
 
92542
51 386   1
2/3/2009
11
 
92543
51 386   4
2/4/2009
11
 
92544
51 386   1
2/5/2009
11
 
92547
51 386   7

Note: You do not need (+) appended to CPT Code 92547 when billing the insurer.

Reviewed June 2009

Reviewed July 2006

Important Disclaimer Notice (Updated 8/7/14)

CPT for ENT articles are a collaborative effort between the Academy’s team of CPT Advisors, members of the Physician Payment Policy (3P) workgroup, and health policy staff. Articles are developed to address common coding questions received by the health policy team, as well as to clarify coding changes and correct coding principles for frequently reported ENT procedures. These articles are not intended as legal, medical, or business advice and are not a guarantee of reimbursement. The information is also not meant to serve as the definitive or sole authority on billing and coding issues. The applicability of AAO-HNS billing and coding guidance for a particular procedure, must be determined by the responsible physician in light of all the circumstances presented by the individual patient. You should consult with your own advisors as well as Medicare or private carriers in making any decisions about how to bill and code particular services or procedures.