Wiki basic vestibular testing

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Earnose

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Confused the new code 92540 for basic vestibulat evaluation oly for medicare use and still bill all the other VNG codes to private payers. Or is it meant to be used instead of across the board. Also can some one provide me with the best resource for medicare 2010 updates to print for the Doctors. Thank YOu
 
Earnose

The fee schedule has not yet been agreed on so do not go by it. Refer to you 2010 cpt book pages 451 & 452. They have also created a new code to report a combined test of the Tymps(92567) and Reflex(92568) testing 92550. To report tymps, reflex and acoustic reflex use the one code 92570. I hope this helps. Email me celesrosa@yahoo.com.
 
92540 is a new code which includes 92541, 92542, 92544 and 92545. 92547 is an add-on code to 92541, 92542, 92544 and 92545. What about 92540? If this new code should be billed instead of those four codes when performing all four tests what do you do if also performing 92547? Are we to unbundle or fight for payment of 92547? If performing 92540 and 92547, how many units of 92547, is it now 1 or is it 4? thank you, Dawn
 
2010 Audio Billing & Reimbursement Webinar today - ASHA

All,

According to the folks from ASHA, 92540 does replace 92541,42, 44, and 45 across the board - not just MC.

If when performing the parts of 92540 the audiologist is unable to finish or only does 2 or 3 'parts' of the code, you can only code 92540 with the 52 modifier. The intention is you can only individually code either 41,42,44, or 45 and not more than one each day without raising a red flag.

There is some work by ASHA and other organizations to change this, but at this time, you should only report a 92540 - 52 if completing only 2 or 3 of the codes.

The 92547 code is a focus of RACs across the country now. They should only be charged ONCE each day and only with vertical testing. An Audiology practice in FL had to pay back >$130k to MC after a RAC went through their coding. An ENT practice in FL had to pay back over $300k.

ASHA's webinar today will be available on demand as well if you are interested. Just go to their website and you can pay/download the webinar to review.

Makes you wonder if VNGs are even worth doing at this point? If it wasn't that the physicians need the info to develop their Dx, we probably wouldn't be performing them anymore.

Diane
 
vestibular evaluation coding

Per tech company that we have the equipment from, their biller said to code Basic Vestibular Testing: 92540 (59), Use of Vertical Electrodes: 92547 x 5 (59), Sinusoidal Rotation Test: 92546 x 1 (59), 92546 x 1 (59) (76), Electro-Occulography: 92270 x 1 (59), 92270 x 1 (59) (76). This seemed rather odd to me with all the modifiers... any suggestions???
 
"Makes you wonder if VNGs are even worth doing at this point? If it wasn't that the physicians need the info to develop their Dx, we probably wouldn't be performing them anymore."

Shouldn't medical necessity have been the only reason to perform ANY test in the first place?
 
are you receiving smart edit rejections from medicare's EDI department for # of units allowed for 92547. we billed 92547 x5 with 92540 and 92543. have you experience this ?
 
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