Otolaryngology Coding Alert

Question: When my audiologist uses our new video electronystagmography machine, I bill four units of 92547 - one for each electrode that she places. Payers continually deny the extra units. What advice do you have to encourage them to cover the services?

New Jersey Subscriber Answer: You shouldn't charge +92547 (Use of vertical electrodes [list separately in addition to code for primary procedure]) per electrode. The code actually describes using multiple electrodes - not a single electrode. The plural means you should bill 92547 each time the audiologist places electrodes on the patient, not per piece. Because she places the electrodes once, you should bill one unit of 92547 in addition to the primary code (92541-92546, Vestibular function tests).

Because 92547 is an add-on code, you shouldn't append modifier -51 (Multiple procedures) to it or expect a multiple-procedure reduction. The insurer should pay 92547 at 100 percent. If the payer applies a reduction, you should appeal for the full fee. - Answers to Reader Questions and You Be the Coder provided by Jami Lucas, executive director at the American Association of Otolaryngic Allergy in Washington, D.C.; Betsy Nicoletti, CPC, a consultant with Helms & Company, a physician practice management company in Concord, N.H.; and Teresa Thompson, CPC, CCC, a nationally recognized speaker on otolaryngology coding, compliance and reimbursement and president of TM Consulting in Carlsburg, Wash.