Otolaryngology Coding Alert

Question: My otolaryngologist maneuvers a patient's head through a series of positions in a particular order in an effort to reposition the small canaliths that have wended their way into the patient's semicircular canals. For the manual therapy, should I use 97140?

Texas Subscriber

Answer: Code 97140 (Manual therapy techniques [e.g., mobilization/manipulation, manual lymphatic drainage, manual traction], one or more regions, each 15 minutes) is an outdated billing recommendation for the canalith repositioning procedure (CRP) that your otolaryngologist performs. You should now assign the payer-specific code.

For most payers, you should assign 92700 (Unlisted otorhinolaryngological service or procedure) for CRP. But, some private payers require a HCPCS code, such as A9270 (Noncovered item or service) or S9092 (Canolith repositioning, per visit) for the procedure.

For more information on payer-specific requirements, read February 2004 Otolaryngology Coding Alert's article "3 Tips Guide You Through Payer-Specific CRP Coding" available at www.osslogin.com/content/oss_admin2/cgi/member_login.cgi?action=view_article&article=45874&keywords=dix-hallpike or "The Canalith Repositioning Procedure (CRP)" by Gregory L. Schnitzer, RN, CPC, CPC-H, CCS-P, at coderyte.com/Canalith_Article.htm.