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VNG / ENG
VHIT / AHR / DVA
Rotational Chair
Rotational Chair
Video Goggles
Air Fx Air Caloric Irrigator
Caloric Irrigator
Caloric Irrigator
Codes and Billing Information
Source: CPT Professional Edition 2007 by the American Medical Association

Vestibular Function Tests with Recording (e.g. ENG) and Medical Diagnostic Evaluation
Following each code are three descriptions of various tests done with Micromedical Technologies instrumentation.
  1. Name of the test as listed in the CPT codes.
  2. A single sentence often used in medical billing.
  3. A rather long paragraph would be appropriate for appending to a super bill.

Basic Vestibular Testing
CPT 92540 Combines CPT Codes 92541 (Nystagmus), 92542 (Positional Nystagmus), 92544 (OKN / OPK), and 92545 (Smooth Pursuit)
Brief: Vestibular test battery of spontaneous nystagmus, positional nystagmus, optokinetic, and smooth pursuit tests.
Extended: Vestibular test battery to measure the inability of the eyes to maintain a static position when the head is in different positions, as well as to measure the patient's ability to keep moving visual targets registered on the fovea.

Nystagmus
CPT 92541 Spontaneous nystagmus test, including gaze and fixation nystagmus, with recording
Brief: These nystagmus tests document and measure the inability of the eyes to maintain a static position as a result of peripheral, CNS or congenital abnormality.
Extended: These nystagmus tests document and measure the inability of the eyes to maintain a static position as a result of peripheral, CNS or congenital abnormality.  The tests are conducted with the eyes open and closed and in 'eyes forward' as well as 'eyes right' and 'eyes left' positions.

Positional Nystagmus
CPT 92542 Positional nystagmus test, minimum of four positions, with recording
Brief: These spontaneous nystagmus tests document and measure the inability of the eyes to maintain a static position when the head is in different positions.
Extended: These spontaneous nystagmus tests document and measure the inability of the eyes to maintain a static position when the head is in different positions. These tests are valuable to document and quantify patient complaints of dizziness in certain situations or positions. Moreover, they are sometimes helpful to localize the abnormality as CNS or peripheral.

Calorics
CPT 92543 Caloric vestibular test, each irrigation (binaural bithermal stimulation constitutes four tests), with recording
Brief: The caloric tests evaluate the viability of the peripheral end organs by stimulating them with warm and cool water.
Extended: The caloric tests evaluate the viability of the peripheral end organs by stimulating them with warm and cool water while the patient's eyes are closed. The resulting dizziness and nystagmus is taken as an index of the viability of the organ. The eyes are then opened to evaluate the ability of the CNS to visually suppress inappropriate dizziness and nystagmus.

OKN or OPK
CPT 92544 Optokinetic nystagmus test, bidirectional, foveal or peripheral stimulation, with recording
Brief: The optokinetic test documents and measures eye movements as the patient watches a series of targets moving simultaneously.
Extended: The optokinetic test documents and measures eye movements as the patients watches a series of targets moving simultaneously to the right and then to the left. The optokinetic mechanism is at work when the visual movement in one direction encompasses more than a single point.
Tracking or Smooth Pursuit
CPT 92545 Oscillating tracking test, with recording
Brief: This test evaluates the ability of the patient to keep a moving visual target registered on the fovea.
Extended: This test evaluates the ability of the patient to keep a moving visual target registered on the fovea. The patient watches a light as it moves back and forth in a smooth pendular fashion. The computer computes the gain (target velocity divided by eye velocity) and compares the gain to age matched norms.

Rotational Chair Test (SHA - Low Frequency)
CPT 92546 Sinusoidal vertical axis rotational testing
Brief: This is a computerized slow harmonic acceleration rotation test to evaluate the integrity of the vestibular-ocular system.
Extended: This is a computerized slow harmonic acceleration rotation test to evaluate the integrity of the vestibular-ocular system. The test lasts for 30-40 minutes and is completely run under computer control. This is an essential part in the evaluation of the dizzy patient as it reflects the relationship between natural head and eye movements involved in the balance mechanism.

Vertical Leads
CPT 92547 Use of vertical electrodes in any of all of the above tests counts as 1 additional test.

Dynamic Posturography
CPT 92548 Computerized Dynamic Posturography
Description: This is a computerized test that allow various systems that contribute to equilibrium to be assessed.

Therapy Codes
CPT 97110 Therapeutic procedure 1 or more areas, each 15 minutes, therapeutic exercise to develop strength, range of motion
CPT 97112 Neuromuscular reeducation of movement, each 15 minutes

Other Rehabilitative Codes for Use with Vestibular Rehabilitation Therapy (VRT)
CPT 97530 Therapeutic activities, direct (one on one) patient contact by the provider (use of dynamic activities to improve functional performance) each 15 minutes.
CPT 97535 Self care / home management training (e.g. activities of daily living (ADL) and compensatory training, meal preparation, safety procedures, and instructions in use of adaptive equipment) direct (one on one) contact by provider, each 15 minutes.
CPT 97537 Community / work reintegration training (e.g. shopping, transportation, money management, avocational activities and / or work environment / modification analysis, work task analysis), direct (one on one) contact by provider, each 15 minutes
CPT 97750 Physical performance test or measurement (e.g. musculoskeletal, functional capacity) with written report, each 15 minutes.
CPT 97770 Development of cognitive skills to improve attention, memory, problem solving, includes compensatory training and / or sensory integrative activities, direct (one on one) patient contact by the provider, each 15 minutes.