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Wiki Billing for video goggles with audiology services

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triischandler

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Hello, I am reviewing a report where audiology services were performed using video goggles. The code descriptions say electrodes are placed. My question is can the unlisted code be used to bill for the video goggles or are the goggles inclusive of the fee for the code? I have found articles describing VNG vs. ENG but nothing that says goggles are separately billable. Is there anyone that knows this answer or can direct me to a resource? I appreciate it. Medicare is the insurance.
 
Based on you location being listed as Missouri, I'm guessing your Part B MAC is WPS J5, if this isn't the MAC you are submitting these claims to please post which Part B MAC you are submitting claims to. Whenever you ask a question about Medicare FFS coverage/claims it is helpful to know who the MAC is and what the jurisdiction is.

Anyway, I could not find a NCD in the Medicare Coverage Database and the only LCDs and Billing & Coding Articles I found were for Part B MACs: First Coast Service Options, Novitas Solutions and Palmetto GBA. Only First Coast Service Options is the only Part B MAC that mentions the use of the goggles. First Coast's Billing & Coding Article A57118-Vestibular Function Tests describes 92537 as complete caloric vestibular testing which includes utilizing the goggles.

While the other 2 Part B MACs didn't mention the goggles and the silence of the remaining Part B MACs don't address the use of goggles for audiology services, my gut instinct is that there isn't a separately billable charge for use of the goggles.

You can certainly try and bill an unlisted code and submit the description of the service to see if your MAC will reimburse for it, you might also want to submit medical records with the unlisted code. Although, receiving reimbursement doesn't mean it is covered claims are processed incorrectly all the time. It would be unfortunate if you submit claims with an unlisted code and are paid on numerous claims only for the MAC to come back and say "Opps, this service should've been denied as included in the charge for the audiology service performed" and then you have a bunch of overpayments to deal with.

You might contact your Part B MAC to see if they have any insight into coverage of this service.
 
Thank you so much for your time and research. As I was unable to find any rules governing use of goggles, I relied on CMS' claims processing manual for physicians. The RVU calculation includes costs for productivity-enhancing technology.
 
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