Neurology & Pain Management Coding Alert

Question: Which codes are applicable to vestibular testing in an office setting with an ENG machine?

Iowa Subscriber

Answer: ENG (electronystagmography) refers to the recording of ocular nystagmus or eye movements by electrooculography in response to vestibular dysfunction.

During ENG testing, the eye movements are recorded and analyzed by placing small electrodes on the skin around the eyes. There are seven CPT codes most often associated with ENG machines. They typically are used for diagnosis codes 780.4 (Dizziness and giddiness) and 386.11 (Benign paroxysmal positional vertigo).

The codes include:

" 92541 -- Spontaneous nystagmus test, including gaze and fixation nystagmus, with recording (1 unit)

" 92542 -- Positional nystagmus test, minimum of 4 positions, with recording (1 unit)

" 92543 -- Caloric vestibular test, each irrigation (binaural, bithermal stimulation constitutes four tests), with recording (4 units)

" 92544 -- Optokinetic nystagmus test, bidirectional, foveal or peripheral stimulation, with recording (1 unit)

" 92545 -- Oscillating tracking test, with recording (2 units)

" 92546 -- Sinusoidal vertical axis rotational testing (2 units)

" +92547 -- Use of vertical electrodes (List separately in addition to code for primary procedure) (2 units).