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Electronystagmography (ENG) & Coding Vestibular Autorotation Test (VAT) coding

Sangeeta Posted Sat 05th of April, 2014 14:05:24 PM

We are doing VAT-ENG plus Combo Procedure in office. The reimbursement codes which was given by the vendor are -
ENG -
92541,
92542,
92545,
92547(to be billed X 3)

VAT -
92546
92270 (to be billed X 2)

I would like to know that are we supposed to bill all the codes mentioned here same time for each patient.

Please help, how to bill this procedure correctly in office setting and also in hospital outpatient department setting.

Thanks

SuperCoder Answered Tue 08th of April, 2014 11:29:54 AM

It seems to me that the trickiest part of coding this encounter will be accounting for coding edits. When you check the latest edition of CCI, you find that several of the codes mentioned are bundled:

92541 is a Col 2 code for 92270
92542 is a Col 2 code for 92541
92545 also is a Col 2 code for 92541
92546 is a Col 2 code for 92547

So, determining which codes need modifiers and which don't will be a bit like putting a puzzle together. Of course, the modifier goes with the Col 2 code of the pair you're reporting.

Another important note is that 92547 is not an ASC approved procedure/code. It can be reported for accuracy's sake, but won't be reimbursed (and I'm not sure if submitting a non-approved ASC code will lead to denial of the entire claim or not -- if so, they'll need to resubmit without 92547). And, if 92547 isn't on the claim, a modifier won't be necessary on 92546.

Also -- the remaining codes (92541, 92542, 92545, 92546 and 92270) are approved for hospital outpatient departments, but not freestanding ASCs.

The same coding guidelines/coding edits will apply if the procedure is done in-office. However, 92547 may be billable in an office situation even though it isn't for an outpatient department.

SuperCoder Answered Tue 08th of April, 2014 11:29:54 AM
With me
SuperCoder Answered Thu 17th of April, 2014 13:32:37 PM

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