Neurology & Pain Management Coding Alert

Question: My provider documented codes 92540, 92543, 92545, and 92546 for billing. The combination fails when I check it against edits. What needs to change?

Louisiana Subscriber

Answer: CPT® includes the following parenthetical note, “Do not report 92545 in conjunction with 92270, 92540 or the set of 92541, 92542, and 92544.” Bill the service as follows:

• 92546 (Sinusoidal vertical axis rotational testing)
• 92540 (Basic vestibular evaluation, includes spontaneous nystagmus test with eccentric gaze fixation nystagmus, with recording, positional nystagmus test, minimum of 4 positions, with recording, optokinetic nystagmus test, bidirectional foveal and peripheral stimulation, with recording, and oscillating tracking test, with recording)
• 92543 (Caloric vestibular test, each irrigation [binaural, bithermal stimulation constitutes 4 tests], with recording).

Also according to CCI edits, you cannot bill 92545 (Oscillating tracking test, with recording) with 92540 in any circumstances. Including 92545 could be why your check is failing.