Otolaryngology Coding Alert

Question: When we bill 92543, does that code represent the four irrigations as one unit or do we bill four units?

Texas Subscriber

Answer: You should bill procedure code 92543 (Caloric vestibular test, each irrigation [binaural, bithermal stimulation constitutes 4 tests], with recording) per irrigation.

In an example such as yours, report 92543 x 4 when your provider uses electroneurography (ENG) to record caloric vestibular testing on a patient’s right and left ears, hot and cold readings. CPT® notes that dual temperature ear irrigations on both ears equal four tests.

Some payers don’t accept units. In that case, you should bill one irrigation per line and append modifier 59 (Distinct procedural service) to each additional irrigation. Check with the individual payer for the latest reporting requirements.