CPT for ENT: Vertical Electrodes

Q: How do you code for the use of vertical electrodes in vestibular function tests? (CPT Code +92547: use of vertical electrodes (List separately in addition to code for primary procedure)

A: Most vestibular testing is performed using VNG (video nystagmography) rather than ENG (Electronystagmography).  Use of add on code +92547 is not appropriate for documentation of vertical eye movements on video nystagmography.

For those practices still using electrodes, 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 further discusses that CMS valued +92547 as intended to be reported with each vestibular test performed.  Based on the valuation method of this service, it would be appropriate to report +92547 with each vestibular test performed if, in fact, vertical electrodes are used during an ENG and not a VNG.

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

Reviewed October 2023

IMPORTANT DISCLAIMER NOTICE

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.