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Official Description

Sinusoidal vertical axis rotational testing

© Copyright 2026 American Medical Association. All rights reserved.

Common Language Description

A sinusoidal vertical axis rotational test, designated by CPT® Code 92546, is a specialized diagnostic procedure that assesses the functionality of the vestibular-ocular system. This test is crucial for understanding how well the eyes and inner ear work together to maintain balance and coordinate eye movements. During the procedure, electronystagmography (ENG) is utilized to record eye movements, providing valuable data on the patient's vestibular function. The test involves the patient being seated in a rotational chair, where they undergo a controlled, slow, harmonic acceleration rotation that typically lasts between 30 to 40 minutes. This method allows for a comprehensive evaluation of the relationship between natural head movements and corresponding eye movements, which are essential components of the body's balance mechanism. Horizontal electrodes are strategically placed on the skin at both the inner and outer aspects of each eye to capture precise eye movement data. Following the test, the physician meticulously reviews the recorded data to analyze and interpret the results, aiding in the diagnosis of any vestibular disorders or dysfunctions.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

The sinusoidal vertical axis rotational test is indicated for various conditions that may affect the vestibular system and balance. The following are the explicitly provided indications for performing this test:

  • Vestibular Disorders Evaluation of patients suspected of having vestibular dysfunction, which may manifest as dizziness, vertigo, or balance issues.
  • Balance Assessment Assessment of balance mechanisms in patients experiencing unexplained falls or instability.
  • Ocular Motility Disorders Investigation of ocular motility issues that may be related to vestibular system dysfunction.
  • Post-Concussion Symptoms Evaluation of patients with persistent symptoms following a concussion that may involve vestibular components.

2. Procedure

The sinusoidal vertical axis rotational test involves several key procedural steps that ensure accurate assessment of the vestibular-ocular system. Each step is critical for obtaining reliable data.

  • Step 1: Patient Preparation The patient is prepared for the test by ensuring that they are comfortable and informed about the procedure. It is essential to explain the process to alleviate any anxiety and to ensure cooperation during the test.
  • Step 2: Electrode Placement Horizontal electrodes are carefully placed on the skin at the inner and outer aspects of each eye. This placement is crucial for accurately recording eye movements during the test.
  • Step 3: Positioning in Rotational Chair The patient is seated in a specialized rotational chair designed for the test. This chair allows for controlled rotation, which is essential for the sinusoidal testing method.
  • Step 4: Initiation of Rotation The test begins with a slow, harmonic acceleration rotation of the chair, which lasts approximately 30 to 40 minutes. This controlled movement is performed under computer control to ensure precision.
  • Step 5: Data Recording During the rotation, the ENG system records the eye movements. This data collection is vital for analyzing the vestibular-ocular response to the rotational stimulus.
  • Step 6: Data Analysis After the completion of the rotation, the physician reviews the recorded data. This analysis involves interpreting the eye movement patterns in relation to the head movements to assess the integrity of the vestibular system.

3. Post-Procedure

Post-procedure care for the sinusoidal vertical axis rotational test typically involves monitoring the patient for any immediate side effects, such as dizziness or disorientation, which may occur due to the nature of the test. Patients are usually advised to rest briefly after the procedure to allow any residual effects to subside. The physician will discuss the findings from the test with the patient, providing insights into the results and any further steps that may be necessary based on the analysis. Follow-up appointments may be scheduled to address any ongoing symptoms or to discuss treatment options if vestibular dysfunction is identified.

Short Descr SINUSOIDAL ROTATIONAL TEST
Medium Descr SINUSOIDAL VERTICAL AXIS ROTATIONAL TESTING
Long Descr Sinusoidal vertical axis rotational testing
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)
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.
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.
KX Requirements specified in the medical policy have been met
GA Waiver of liability statement issued as required by payer policy, individual case
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.
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
XE Separate encounter, a service that is distinct because it occurred during a separate encounter
LT Left side (used to identify procedures performed on the left side of the body)
RT Right side (used to identify procedures performed on the right side of the body)
XU Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service
XS Separate structure, a service that is distinct because it was performed on a separate organ/structure
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).
GW Service not related to the hospice patient's terminal condition
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).
53 Discontinued procedure: under certain circumstances, the physician or other qualified health care professional may elect to terminate a surgical or diagnostic procedure. due to extenuating circumstances or those that threaten the well being of the patient, it may be necessary to indicate that a surgical or diagnostic procedure was started but discontinued. this circumstance may be reported by adding modifier 53 to the code reported by the individual for the discontinued procedure. note: this modifier is not used to report the elective cancellation of a procedure prior to the patient's anesthesia induction and/or surgical preparation in the operating suite. for outpatient hospital/ambulatory surgery center (asc) 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).
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.)
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
GV Attending physician not employed or paid under arrangement by the patient's hospice provider
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
PD Diagnostic or related non diagnostic item or service provided in a wholly owned or operated entity to a patient who is admitted as an inpatient within 3 days
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