Codes 92541-92548

falconfans

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Rantou, IL
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I was wondering if anyone could help me with the above codes? I am a new
CPC and have never done any of this billing before. My doc is looking at doing
these procedures. Is there anything that I should be aware of regarding the above codes. Thanks in advance for any help that you can give!

Rhonda Long
 

rimiller

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i have been billing these for a while. I learned not to long ago that the only code that can be billed in multiple units is the 92543. 92541,42,44,45 are only 1 unit.:)
 

debz

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our office bills out 92541, 92542, 92544 with 1 unit ( bcbs and medicare pay only 1 unit on 92545 & 92546) other insuranes pay for 2 units, 92543 is billed out with 4 units and 92547 is billed out with 11 units
 

falconfans

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Rantou, IL
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Thanks so much for the replies. Does anyone know if you can bill 92546 with 2 units?

Thanks,
Rhonda Long
Paxton Clinic
227 N Market St
Paxton IL 60957
217 379 4864
 

debz

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here in CT our office bills 2 units on 92546 to all carriers except BCBS and medicare they will only pay 1 unit
 

nilamdesale

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Hi,
Can anybody help me for coding for 92541-92545 Series, its continuously getting denials for 92542,92543,92544. Thanks in advance
 

catharinen

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If billing 92541, 92542, 92544, and 92545 on the same day, you should use 92540 instead of billing them individually. If not performing all four codes on the same day, you can bill the individual CPT codes. In my state, Medicare will only pay for 2 the following per patient per year: 92541, 92542, 92544, 92545, 92546 if billed individually. Also, they will only pay for 4 units of 92543 within a calendar year.
 
Last edited:

mbwhite

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Medicare is paying 92548 but I am getting denials from the commercial insurances. Is anyone billing 92548 and getting paid or is there another cpt code we should be using for Physical Therapy.
 

b.cobuzzi

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92548 is not physical therapy, MBWhite. It is a diagnostic test:
Lay Description
The provider performs computerized dynamic posturography sensory organization testing to evaluate the patient's motor, sensory, and integrative processes used to maintain balance and stability. The test is carried out using 6 specific conditions specified in the descriptor. This code represents both the technical and professional components of the service.

Clinical Responsibility
This code represents the technical and professional components of a service in which the provider evaluates the patient’s posture and balance under various conditions. The patient stands on a support platform that can tilt up and back and rotate. The provider assesses the patient’s balance with tests involving elements such as the sense of touch in the lower extremities, vision, and the vestibular system of the inner ear and brain. To collect the data, the provider asks the patient to stand on a platform with force plates surrounded by a visual field. The patient wears a harness so that he does not fall. The provider begins the automated test, which often starts by altering the angle of the platform on which the patient is standing and shifting the visual field. The provider monitors visual and vestibular information relevant to postural control. The stages of the tests vary but must include testing with the patient’s eyes open and closed on a fixed platform, shifting of the visual field (visual sway), moving the platform (platform sway), platform sway with eyes closed, and combined visual and platform sway. Each stage is conducted for 30 seconds. The provider records these changes using electromyography. The provider reviews any unusual or inconsistent findings before completion of the study so that he can repeat testing fully or in part as needed. The provider interprets the findings and prepares a report.

So, although Medicare is paying for the code when you submit it, are they paying for the service you provided? Are you performing a PT service or are you doing CDP diagnostic testing? If you are not doing CDP diagnostic testing, you need to do a voluntary refund to Medicare for all of the payments you have received because the claims were improperly coded.

If you are not performing CDP diagnostic testing, what type of PT are you performing? Can you describe it and then perhaps we can work on the correct coding. And, I suggest you start a new question since this was added to a question about VNG diagnostic testing. Thanks.
 
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