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Official Description

Basic vestibular evaluation, includes spontaneous nystagmus test with eccentric gaze fixation nystagmus, with recording, positional nystagmus test, minimum of 4 positions, with recording, optokinetic nystagmus test, bidirectional foveal and peripheral stimulation, with recording, and oscillating tracking test, with recording

© Copyright 2026 American Medical Association. All rights reserved.

Common Language Description

A basic vestibular evaluation is a comprehensive assessment designed to investigate the presence of nystagmus, which refers to rapid, involuntary eye movements. This evaluation is crucial for diagnosing vestibular disorders that may manifest as vertigo, characterized by sensations of dizziness and balance disturbances. Patients experiencing these symptoms may struggle to maintain their balance, stand upright, or walk normally. The evaluation begins with a visual observation of the patient's eye movements, followed by a series of tests that utilize electronystagmography (ENG) for precise recording. During the evaluation, electrodes are strategically placed on the skin around the eyes to capture and analyze eye movement data. The tests included in this evaluation are specifically structured to assess various aspects of vestibular function, including spontaneous nystagmus, positional nystagmus, optokinetic nystagmus, and oscillating tracking abilities. Each component of the evaluation is designed to elicit specific responses that can help identify underlying vestibular disorders, providing essential information for further diagnosis and treatment planning.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

The basic vestibular evaluation is indicated for patients presenting with symptoms that suggest vestibular dysfunction. These indications include:

  • Vertigo - A sensation of spinning or dizziness that may be associated with balance disturbances.
  • Balance disturbances - Difficulty maintaining balance, standing upright, or walking normally.
  • Nystagmus - The presence of involuntary eye movements that may indicate vestibular system issues.
  • Unexplained dizziness - Dizziness that cannot be attributed to other medical conditions.

2. Procedure

The basic vestibular evaluation consists of several key procedural steps designed to assess the vestibular system comprehensively. Each step is critical for obtaining accurate diagnostic information.

  • Spontaneous Nystagmus Test - The evaluation begins with the spontaneous nystagmus test, where the physician observes the patient's eye movements without any external stimuli. The patient is instructed to look straight ahead for 30 seconds, allowing the physician to assess any involuntary eye movements. Following this, the patient is asked to fixate on a target positioned 30 degrees to the right for 10 seconds, after which the gaze is returned to the center. This process is repeated for targets positioned to the left, above, and below, allowing for a thorough assessment of eye movement in various directions.
  • Positional Nystagmus Test - Next, the positional nystagmus test is conducted. The patient is placed in a minimum of four different positions to evaluate how head and body movements affect nystagmus and vertigo. Standard positions include head hanging forward, supine, and lateral positions, among others. Eye movements are recorded during each position to identify any abnormal responses that may indicate dysfunction in the semicircular canals of the middle ear.
  • Optokinetic Nystagmus Test - The optokinetic nystagmus test follows, where the patient is exposed to moving visual stimuli. The patient watches a series of targets that move simultaneously to the right and then to the left. These targets can include stripes on a rotating drum or a stream of lighted dots. The speed of the moving targets is varied, and eye movements are recorded to evaluate the symmetry of the response. Asymmetrical responses may suggest central nervous system pathology.
  • Oscillating Tracking Test - Finally, the oscillating tracking test is performed to assess the patient's ability to track a moving visual target. The patient is instructed to follow a pendulum, metronome, or computer-generated stimulus as it moves back and forth. Eye movements are recorded, and a computer calculates the gain, which is the ratio of target velocity to eye velocity. This gain is then compared to age-matched norms to determine the patient's tracking ability.

3. Post-Procedure

Upon completion of the vestibular evaluation, the recorded data is thoroughly reviewed and interpreted by the physician. A written report detailing the findings is generated, which may include observations regarding the presence of nystagmus, balance disturbances, and any other relevant abnormalities noted during the tests. This report serves as a critical component for further diagnostic considerations and treatment planning for the patient.

Short Descr BASIC VESTIBULAR EVALUATION
Medium Descr VSTBLR FUNCJ NYSTAG FOVL&PERPH STIMJ OSCIL TRK
Long Descr Basic vestibular evaluation, includes spontaneous nystagmus test with eccentric gaze fixation nystagmus, with recording, positional nystagmus test, minimum of 4 positions, with recording, optokinetic nystagmus test, bidirectional foveal and peripheral stimulation, with recording, and oscillating tracking test, with recording
Status Code Active Code
Global Days XXX - Global Concept Does Not Apply
PC/TC Indicator (26, TC) 1 - Diagnostic Tests for Radiology Services
Multiple Procedures (51) 0 - No payment adjustment rules for multiple procedures apply.
Bilateral Surgery (50) 0 - 150% payment adjustment for bilateral procedures does NOT apply.
Physician Supervisions 09 - Concept does not apply.
Assistant Surgeon (80, 82) 0 - Payment restriction for assistants at surgery applies to this procedure...
Co-Surgeons (62) 0 - Co-surgeons not permitted for this procedure.
Team Surgery (66) 0 - Team surgeons not permitted for this procedure.
Diagnostic Imaging Family 99 - Concept Does Not Apply
APC Status Indicator Procedure or Service, Not Discounted when Multiple
Type of Service (TOS) 1 - Medical Care
Berenson-Eggers TOS (BETOS) T2D - Other tests - other
MUE 1
CCS Clinical Classification 220 - Ophthalmologic and otologic diagnosis and treatment

This is a primary code that can be used with these additional add-on codes.

92547 Addon Code MPFS Status: Active Code APC N CPT Assistant Article Use of vertical electrodes (List separately in addition to code for primary procedure)
26 Professional component: certain procedures are a combination of a physician or other qualified health care professional component and a technical component. when the physician or other qualified health care professional component is reported separately, the service may be identified by adding modifier 26 to the usual procedure number.
59 Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25.
TC Technical component; under certain circumstances, a charge may be made for the technical component alone; under those circumstances the technical component charge is identified by adding modifier 'tc' to the usual procedure number; technical component charges are institutional charges and not billed separately by physicians; however, portable x-ray suppliers only bill for technical component and should utilize modifier tc; the charge data from portable x-ray suppliers will then be used to build customary and prevailing profiles
GA Waiver of liability statement issued as required by payer policy, individual case
GY Item or service statutorily excluded, does not meet the definition of any medicare benefit or, for non-medicare insurers, is not a contract benefit
CR Catastrophe/disaster related
52 Reduced services: under certain circumstances a service or procedure is partially reduced or eliminated at the discretion of the physician or other qualified health care professional. under these circumstances the service provided can be identified by its usual procedure number and the addition of modifier 52, signifying that the service is reduced. this provides a means of reporting reduced services without disturbing the identification of the basic service. note: for hospital outpatient reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well-being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use).
GZ Item or service expected to be denied as not reasonable and necessary
GW Service not related to the hospice patient's terminal condition
24 Unrelated evaluation and management service by the same physician or other qualified health care professional during a postoperative period: the physician or other qualified health care professional may need to indicate that an evaluation and management service was performed during a postoperative period for a reason(s) unrelated to the original procedure. this circumstance may be reported by adding modifier 24 to the appropriate level of e/m service.
25 Significant, separately identifiable evaluation and management service by the same physician or other qualified health care professional on the same day of the procedure or other service: it may be necessary to indicate that on the day a procedure or service identified by a cpt code was performed, the patient's condition required a significant, separately identifiable e/m service above and beyond the other service provided or beyond the usual preoperative and postoperative care associated with the procedure that was performed. a significant, separately identifiable e/m service is defined or substantiated by documentation that satisfies the relevant criteria for the respective e/m service to be reported (see evaluation and management services guidelines for instructions on determining level of e/m service). the e/m service may be prompted by the symptom or condition for which the procedure and/or service was provided. as such, different diagnoses are not required for reporting of the e/m services on the same date. this circumstance may be reported by adding modifier 25 to the appropriate level of e/m service. note: this modifier is not used to report an e/m service that resulted in a decision to perform surgery. see modifier 57 for significant, separately identifiable non-e/m services, see modifier 59.
51 Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d).
76 Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service.
77 Repeat procedure by another physician or other qualified health care professional: it may be necessary to indicate that a basic procedure or service was repeated by another physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 77 to the repeated procedure or service. note: this modifier should not be appended to an e/m service.
79 Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.)
95 Synchronous telemedicine service rendered via a real-time interactive audio and video telecommunications system: synchronous telemedicine service is defined as a real-time interaction between a physician or other qualified health care professional and a patient who is located at a distant site from the physician or other qualified health care professional. the totality of the communication of information exchanged between the physician or other qualified health care professional and the patient during the course of the synchronous telemedicine service must be of an amount and nature that would be sufficient to meet the key components and/or requirements of the same service when rendered via a face-to-face interaction. modifier 95 may only be appended to the services listed in appendix p. appendix p is the list of cpt codes for services that are typically performed face-to-face, but may be rendered via a real-time (synchronous) interactive audio and video telecommunications system.
AB Audiology service furnished personally by an audiologist without a physician/npp order for non-acute hearing assessment unrelated to disequilibrium, or hearing aids, or examinations for the purpose of prescribing, fitting, or changing hearing aids; service may be performed once every 12 months, per beneficiary
AQ Physician providing a service in an unlisted health professional shortage area (hpsa)
AT Acute treatment (this modifier should be used when reporting service 98940, 98941, 98942)
CC Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed)
CQ Outpatient physical therapy services furnished in whole or in part by a physical therapist assistant
GC This service has been performed in part by a resident under the direction of a teaching physician
GK Reasonable and necessary item/service associated with a ga or gz modifier
GP Services delivered under an outpatient physical therapy plan of care
GV Attending physician not employed or paid under arrangement by the patient's hospice provider
GX Notice of liability issued, voluntary under payer policy
KX Requirements specified in the medical policy have been met
LT Left side (used to identify procedures performed on the left side of the body)
Q6 Service furnished under a fee-for-time compensation arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area
XU Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service
Date
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Notes
2013-01-01 Changed Medium Descriptor changed.
2010-01-01 Added -
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