Otolaryngology Coding Alert

Question: Should I use an unlisted procedure code for canalith repositioning (a.k.a. Epley maneuvers)?

New Mexico Subscriber

Answer: No need to report an unlisted procedure,thanks to a new code introduced this year: 95992 (Canalith repositioning procedure[s] [e.g., Epley maneuver, Semont maneuver], per day). The trouble is Medicare will deny payment for it.

Why: Medicare's fee schedule database indicates 95992's status code as "B," which, according to CMS, means it is "always bundled into payment for other services not specified. There will be no payment amount for these codes, and no separate payment is made." In other words, Medicare bundles this service against nothing.

Since 95992's introduction, practices have been confused on its usage. Some have opted to bill 95992 with another service with other payers. Some coders report commercial insurances are paying for this code. Don't preempt your local MAC, however. Check out your MAC's policies first before billing 95992.