How To Use CPT Code 92538

CPT 92538 describes a caloric vestibular test with recording, specifically a monothermal test involving the irrigation of both ears with water. This article will cover the official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes and billing examples.

1. What is CPT Code 92538?

CPT 92538 is used to describe a caloric vestibular test with recording, specifically a monothermal test. This test involves the sequential irrigation of both ears with water, either warm or cool, but not both. The purpose of this test is to evaluate the patient’s eye movements and measure the disturbance in their vestibular system, which is responsible for balance and hearing.

2. Official Description

The official description of CPT code 92538 is: ‘Caloric vestibular test with recording, bilateral; monothermal (i.e., one irrigation in each ear for a total of two irrigations).’ It is important to note that this code should not be reported in conjunction with CPT codes 92270 or 92537. For one irrigation, modifier 52 should be used. For bilateral, bithermal caloric vestibular testing, CPT code 92537 should be used.

3. Procedure

  1. The healthcare provider begins by placing electronystagmography electrodes around the patient’s eyes or using infrared videonystagmography goggles to record eye movements.
  2. The provider then sequentially irrigates each ear with either warm or cool water.
  3. During the irrigation, the provider observes the patient for any differences in reaction between the left and right ear irrigations.
  4. The provider records the findings, including any nystagmus (involuntary eye movements) observed during the test.

4. Qualifying circumstances

CPT 92538 is typically performed on patients who are experiencing balance or vestibular disorders. The test helps assess the function of the nerves involved in hearing and balance. It is important to note that this code should not be reported with CPT codes 92270 or 92537.

5. When to use CPT code 92538

CPT code 92538 should be used when a healthcare provider performs a caloric vestibular test with recording using monothermal irrigation. This code should not be used in conjunction with CPT codes 92270 or 92537. Modifier 52 should be used if only one irrigation is performed.

6. Documentation requirements

To support a claim for CPT 92538, the healthcare provider must document the following information:

  • Patient’s symptoms or suspected vestibular disorder
  • Details of the monothermal caloric vestibular test, including the type of irrigation used (warm or cool)
  • Date and time of the test
  • Observations and findings during the test, including any nystagmus observed
  • Signature of the healthcare provider performing the test

7. Billing guidelines

When billing for CPT 92538, ensure that the test meets the criteria for a monothermal caloric vestibular test with recording. This code should not be reported with CPT codes 92270 or 92537. Modifier 52 should be used if only one irrigation is performed. It is important to follow the specific guidelines provided by the payer to ensure accurate billing and reimbursement.

8. Historical information

CPT 92538 was added to the Current Procedural Terminology system on January 1, 2016. There have been no updates to the code since its addition.

9. Examples

  1. A patient presents with dizziness and balance issues. The healthcare provider performs a monothermal caloric vestibular test with recording, irrigating each ear with warm water and observing the patient’s eye movements.
  2. A patient complains of vertigo. The healthcare provider performs a monothermal caloric vestibular test with recording, irrigating each ear with cool water and documenting the patient’s eye movements during the test.
  3. A patient with a suspected vestibular disorder undergoes a monothermal caloric vestibular test with recording, using warm water irrigation in each ear. The provider records the patient’s eye movements and findings during the test.
  4. A patient experiences recurrent episodes of dizziness. The healthcare provider performs a monothermal caloric vestibular test with recording, using cool water irrigation in each ear and documenting the patient’s eye movements.
  5. A patient presents with balance problems. The healthcare provider performs a monothermal caloric vestibular test with recording, irrigating each ear with warm water and observing the patient’s eye movements during the test.
  6. A patient complains of persistent dizziness. The healthcare provider performs a monothermal caloric vestibular test with recording, using cool water irrigation in each ear and documenting the patient’s eye movements.
  7. A patient with suspected vestibular dysfunction undergoes a monothermal caloric vestibular test with recording, using warm water irrigation in each ear. The provider records the patient’s eye movements and findings during the test.
  8. A patient experiences frequent episodes of vertigo. The healthcare provider performs a monothermal caloric vestibular test with recording, using cool water irrigation in each ear and observing the patient’s eye movements.
  9. A patient presents with balance disturbances. The healthcare provider performs a monothermal caloric vestibular test with recording, irrigating each ear with warm water and documenting the patient’s eye movements during the test.
  10. A patient complains of recurrent dizziness. The healthcare provider performs a monothermal caloric vestibular test with recording, using cool water irrigation in each ear and observing the patient’s eye movements during the test.

Similar Posts

Leave a Reply

Your email address will not be published. Required fields are marked *