Otolaryngology Coding Alert

Question: Can I bill 92700 when an audiologist performs the Epley maneuver?

Missouri Subscriber

Answer: The answer depends on the carrier or payer. Pinnacle Business Solutions Inc., the Part B carrier for Missouri and Rhode Island, allows audiologists to perform the Epley maneuver. "An audiologist as well as a physical therapist can perform the Epley maneuver and code it as 92700," according to the carrier's FAQs.

Nationally, however, CMS will not pay for audiologists performing therapeutic or treatment procedures, such as the Epley maneuver or canalith repositioning procedure (CRP). Audiologists should directly bill carriers for only diagnostic audiological services.

If you bill 92700 (Unlisted otorhinolaryngological service or procedure) incident-to the physician, the claim is blind as to who provided the treatment. So if the encounter and documentation meet incident-to guidelines, you could bill 92700 under the ENT's NPI, which will look as though the physician had performed the service.

Private payers may not carry Medicare's stipulation on treatment versus diagnostic codes. But if a carrier that did not specifically allow audiologists to perform the Epley maneuver audited a practice's files and found that the charts showed an audiologist performed the treatments, the carrier could request paybacks on those services because they are statutorily excluded from coverage.

Good news: Next year, you will probably have a specific code for BPPV (386.11, Benign paroxysmal positional vertigo) treatment methods. The American Academy of Otolaryngology-Head and Neck Surgery with four other academies submitted CRP (959xx) for consideration in CPT 2009.

-- Answers to You Be the Coder and Reader Questions reviewed by Barbara J. Cobuzzi, MBA, CPC-OTO, CPC-H, CPC-P, CPC-I, CHCC, president of CRN Healthcare Solutions in Tinton Falls, N.J.