Otolaryngology Coding Alert

When you bill private insurers for the canalith repositioning procedure (CRP), some payers may follow Medicare's instructions on using 92599 (Unlisted otorhi-nolaryngological service or procedure), if you inform the private payer of Medicare's coverage.

Include the following form letter, which contains an excerpt from Medicare Report, September 1998, with the claim and any appeals, says Barbara Cobuzzi, MBA, CPC, CPC-H, president of Cash Flow Solutions, a medical billing firm in Lakewood, N.J.

Dear Claims Examiner:

Please consider this note as explanation for your use of CPT 92599, an unlisted procedure:

*** Canalith Repositioning Procedure (CRP)

The Canalith Repositioning Procedure (CRP) is a noninvasive series of sequential head maneuvers that are performed in order to move debris (canalithiasis) from the posterior ear canal into the utricle, for the treatment of benign paroxysmal positional vertigo (BPPV).

Since the CRP is considered to be a safe and effective treatment for BPPV (ICD-9 386.11), Medicare will cover this procedure for this condition. Use procedure code 92599 (Unlisted otorhinolaryngological service or procedure) to report CRP, and include the narrative Canalith Repositioning Procedure (CRP). Claims for CRP reporting a diagnosis other than BPPV (386.11) will be denied.

If you have any further questions, you may call. We thank you in advance for your prompt consideration and payment.

Very truly yours,

*** Excerpt from Medicare Report, September 1998.