How To Use CPT Code 95992

CPT 95992 is a code used for canalith repositioning procedures to treat benign paroxysmal positional vertigo. This article will cover the description, procedure, qualifying circumstances, when to use the code, documentation requirements, billing guidelines, historical information, similar codes, and examples of CPT 95992 procedures.

1. What is CPT 95992?

CPT 95992 is a medical billing code used to describe canalith repositioning procedures, such as the Epley maneuver or Semont maneuver, performed by healthcare providers to treat benign paroxysmal positional vertigo (BPPV). BPPV is a condition characterized by sudden episodes of dizziness and vertigo caused by small crystals in the inner ear. Canalith repositioning procedures involve a series of specific head and body movements designed to move these crystals to other areas of the ear, alleviating the symptoms of BPPV.

2. 95992 CPT code description

The official description of CPT code 95992 is: “Canalith repositioning procedure(s) (eg, Epley maneuver, Semont maneuver), per day.”

3. Procedure

The 95992 procedure involves the following steps:

  1. The patient sits upright on an examination table.
  2. The provider quickly moves the patient’s head to one side, usually the side causing the vertigo symptoms.
  3. The provider then moves the patient’s head to the opposite side.
  4. The patient rolls onto their side, facing the unaffected ear.
  5. The provider moves the patient’s head so it is almost facing the floor.
  6. The patient is returned to a sitting position in one movement.
  7. The patient rests in a sitting position to allow the canalith particles to settle.
  8. The provider may repeat the positioning series one or more times, as needed.

The provider observes the patient for dizziness following the procedure and may perform additional repositioning maneuvers if necessary.

4. Qualifying circumstances

Patients eligible to receive CPT code 95992 services are those diagnosed with benign paroxysmal positional vertigo (BPPV) and experiencing symptoms such as dizziness, vertigo, or imbalance. The provider must determine that canalith repositioning is the appropriate treatment for the patient’s condition, based on a thorough examination and evaluation of the patient’s medical history and symptoms.

5. When to use CPT code 95992

It is appropriate to bill the 95992 CPT code when a healthcare provider performs a canalith repositioning procedure to treat a patient diagnosed with BPPV. The code should be reported once per day, per patient, even if the provider performs the positioning series multiple times during the same day.

6. Documentation requirements

To support a claim for CPT 95992, the provider must document the following information in the patient’s medical record:

  • A diagnosis of benign paroxysmal positional vertigo (BPPV).
  • A detailed description of the canalith repositioning procedure performed, including the specific maneuvers used (e.g., Epley maneuver, Semont maneuver).
  • The patient’s response to the procedure, including any improvement or resolution of symptoms.
  • The number of times the positioning series was performed during the day.
  • Any additional treatments or interventions provided for the patient’s condition.

7. Billing guidelines

When billing for CPT code 95992, it is important to follow the appropriate guidelines and rules. The code should be reported once per day, per patient, even if the provider performs the positioning series multiple times during the same day. Additionally, CPT 95992 should not be reported in conjunction with codes 92531 or 92532, as these codes describe different diagnostic tests for balance and vestibular function.

8. Historical information

CPT 95992 was added to the Current Procedural Terminology system on January 1, 2009. There have been no updates to the code since its addition.

9. Similar codes to CPT 95992

Five similar codes to CPT 95992 and how they differentiate from CPT 95992 are:

  1. CPT 92531: This code is used for spontaneous nystagmus testing, which is a diagnostic test for balance disorders, not a treatment like CPT 95992.
  2. CPT 92532: This code is used for positional nystagmus testing, another diagnostic test for balance disorders, not a treatment like CPT 95992.
  3. CPT 92540: This code is used for vestibular function testing, which is a comprehensive evaluation of the vestibular system, not a specific treatment like CPT 95992.
  4. CPT 92541: This code is used for head impulse testing, a diagnostic test for vestibular function, not a treatment like CPT 95992.
  5. CPT 92542: This code is used for caloric vestibular testing, another diagnostic test for vestibular function, not a treatment like CPT 95992.

10. Examples

Here are 10 detailed examples of CPT code 95992 procedures:

  1. A patient with a history of vertigo presents with sudden onset dizziness. The provider diagnoses BPPV and performs an Epley maneuver to treat the condition.
  2. A patient with recurrent BPPV undergoes a Semont maneuver to alleviate vertigo symptoms.
  3. A patient experiences dizziness and imbalance after a head injury. The provider diagnoses BPPV and performs a canalith repositioning procedure.
  4. A patient with a history of BPPV has a recurrence of symptoms and undergoes an Epley maneuver to treat the condition.
  5. A patient presents with vertigo and is diagnosed with BPPV. The provider performs a canalith repositioning procedure, but the patient’s symptoms persist. The provider repeats the procedure later in the day.
  6. A patient with BPPV undergoes a Semont maneuver, followed by a period of observation to assess the effectiveness of the treatment.
  7. A patient with a history of BPPV experiences a sudden onset of vertigo. The provider performs an Epley maneuver, which successfully alleviates the patient’s symptoms.
  8. A patient with BPPV undergoes a canalith repositioning procedure, followed by additional vestibular rehabilitation exercises to improve balance and reduce the risk of recurrence.
  9. A patient with a history of BPPV has a recurrence of symptoms and undergoes a Semont maneuver to treat the condition.
  10. A patient presents with vertigo and is diagnosed with BPPV. The provider performs a canalith repositioning procedure, which successfully alleviates the patient’s symptoms. The patient is advised to return for follow-up care and additional treatment if needed.

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