Barbara Posted Fri 18th of February, 2011 14:52:48 PM
what is the correct way to bill 92541,92542,92543,92544,92545. I am confused about the 92540 code as well
SuperCoder Answered Sat 19th of February, 2011 17:12:16 PM
The change takes effect Oct. 1, 2010, for individual practitioners and Jan. 1, 2011, for outpatient facilities.
According to current Medicare regulations, providers may bill a "bundled" CPT (Current Procedural Terminology, ©American Medical Association) code that includes four vestibular tests. That bundled code (92540, Basic vestibular evaluation) includes codes 92541, 92542, 92544, and 92545. Providers also may bill for any one of those codes; however, they may not bill for any combination of two or three of the codes (see The ASHA Leader, April 6, 2010).
According to CMS, "If two or three of these codes are reported for the same date of service by the same provider for the same beneficiary, an NCCI-associated modifier may be utilized to bypass the NCCI edits." The "-59" (distinct procedural service) modifier should be used when the edits take effect.