Otolaryngology Coding Alert

Question: What is the recent Medicare guideline for billing Canalith repositioning (95992)?

Nevada Subscriber

Answer: Taking effect last Jan. 1, this Medicare rule allows reimbursing physicians separately for 95992 (Canalith repositioning procedure[s] [e.g., Epley maneuver, Semont maneuver], per day) per day. This rule applies for doctors and therapists, and excludes audiologists. Remember, Medicare does not pay audiologists for "therapy;" they only do so for diagnostics. See information from the American Academy of Otolaryngology- Head and Neck Surgery (AAO-HNS) website:

"CMS finalizes its proposal to pay separately for Canalith repositioning (95992), at the RUC's previously recommended work RVUs (0.75) and PE inputs, effective January 1, 2011. Because CPT® 95992 can be furnished by physicians or therapists as therapy services under a therapy plan of care or by physicians as physicians' services outside of a therapy plan of care, the agency will add CPT® 95992 to the 'sometimes therapy' list. Medicare will not reimburse audiologists for performing Canalith repositioning because it is not a diagnostic test."

For more details on this change and to view a summary of the final rule for the CY 2011 Medicare physician fee schedule, you may refer to http://www.entnet.org/Practice/CY2011-MPFS.cfm.