CPT® Code 92549

Official Description

Computerized dynamic posturography sensory organization test (CDP-SOT), 6 conditions (ie, eyes open, eyes closed, visual sway, platform sway, eyes closed platform sway, platform and visual sway), including interpretation and report; with motor control test (MCT) and adaptation test (ADT)

Common Language Description

A computerized dynamic posturography (CDP) test, specifically the computerized dynamic posturography sensory organization test (CDP-SOT), is a specialized assessment designed to evaluate balance impairments in patients. This test is crucial for differentiating between various underlying causes of balance issues, which may be sensory, motor, or central adaptive in nature. During the procedure, the patient stands on a moveable support surface that is housed within a moveable enclosure, allowing for a controlled environment where balance can be tested under different conditions. The use of a computer to manipulate both the support surface and the enclosure enables precise measurement of the patient's balance responses. The CDP-SOT is conducted under six distinct conditions: eyes open, eyes closed, visual sway, platform sway, eyes closed platform sway, and platform and visual sway. These conditions are designed to challenge the patient's vestibular balance control and assess how well the central nervous system adapts to changes in the support surface and visual inputs. By systematically altering the sensory information available to the patient, the test creates scenarios that simulate sensory conflict, which is essential for understanding how the patient’s balance system responds to various stimuli. In addition to the sensory organization test, the procedure includes a motor control test (MCT) and an adaptation test (ADT). The MCT evaluates the patient's ability to recover from unexpected movements of the support surface, assessing the timing, strength, and symmetry of their postural responses. The ADT measures the patient's capacity to adjust their posture and minimize sway when the support surface is tilted in different directions. Throughout the testing process, measurements are carefully controlled and calibrated based on the patient's height and weight, ensuring accurate and reliable results. The outcomes of the tests are presented in standardized graphical formats, which are then compared to age-based norms to provide a comprehensive understanding of the patient's balance capabilities.

1. Indications

The computerized dynamic posturography sensory organization test (CDP-SOT) is indicated for patients experiencing balance impairments. The following conditions may warrant the performance of this test:

Vestibular Disorders Patients with suspected vestibular dysfunction may require this test to evaluate their balance control mechanisms.
Neurological Conditions Individuals with neurological disorders that affect balance, such as multiple sclerosis or Parkinson's disease, may benefit from this assessment.
Postural Instability Patients exhibiting postural instability or frequent falls may be assessed to determine the underlying causes of their balance issues.
Rehabilitation Assessment This test can be used to evaluate balance before and after rehabilitation interventions to measure progress and effectiveness.
Preoperative Evaluation Patients undergoing surgical procedures that may impact balance or vestibular function may be assessed to establish a baseline.

2. Procedure

The procedure for the computerized dynamic posturography sensory organization test (CDP-SOT) involves several key steps to ensure a comprehensive evaluation of the patient's balance capabilities:

Step 1: Patient Preparation The patient is prepared for the test by explaining the procedure and ensuring they understand the importance of maintaining balance during the assessment. The patient's height and weight are recorded to calibrate the equipment accurately.
Step 2: Positioning on the Support Surface The patient is positioned on a moveable support surface within a moveable enclosure. This setup allows for controlled manipulation of the support surface and visual inputs during the test.
Step 3: Conducting the Sensory Organization Test The CDP-SOT is performed under six specific conditions: eyes open, eyes closed, visual sway, platform sway, eyes closed platform sway, and platform and visual sway. Each condition is designed to challenge the patient's balance system by altering sensory information.
Step 4: Performing the Motor Control Test The motor control test (MCT) is conducted by moving the support surface backward and forward. The patient's postural responses are assessed for timing, strength, and lateral symmetry, providing insight into their ability to recover from unexpected movements.
Step 5: Conducting the Adaptation Test The adaptation test (ADT) evaluates the patient's ability to modify their posture and minimize sway as the support surface is tilted in toes up and toes down positions. This step assesses the adaptability of the patient's balance control mechanisms.
Step 6: Data Collection and Analysis Throughout the testing process, data is collected and analyzed. The results are displayed using standardized graphical summaries, which are then compared to age-based norms to evaluate the patient's balance performance.

3. Post-Procedure

After the completion of the computerized dynamic posturography sensory organization test (CDP-SOT), the patient may receive immediate feedback regarding their performance. The results, including graphical summaries and comparisons to age-based norms, are typically discussed with the patient to provide insights into their balance capabilities. Depending on the findings, further evaluation or intervention may be recommended. Patients may be advised on follow-up appointments or additional assessments if necessary. It is important for healthcare providers to document the results thoroughly and consider them in the context of the patient's overall clinical picture for future treatment planning.

Short Descr	CDP-SOT 6 COND W/I&R MCT&ADT
Medium Descr	CDP-SOT 6 CONDITIONS W/I&R W/MCT & ADT
Long Descr	Computerized dynamic posturography sensory organization test (CDP-SOT), 6 conditions (ie, eyes open, eyes closed, visual sway, platform sway, eyes closed platform sway, platform and visual sway), including interpretation and report; with motor control test (MCT) and adaptation test (ADT)
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	STV-Packaged Codes
Type of Service (TOS)	1 - Medical Care
Berenson-Eggers TOS (BETOS)	none
MUE	1

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.
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
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).
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.)
GA	Waiver of liability statement issued as required by payer policy, individual case
GW	Service not related to the hospice patient's terminal condition
KX	Requirements specified in the medical policy have been met
XE	Separate encounter, a service that is distinct because it occurred during a separate encounter