Unbundling the VNG?

Question

If you are not doing the optokinetic nystagmus test (OPK) due to equipment issues, do you need to bill 92540 with a 52 modifier or bill the other aspects individually?

Answer

If you normally perform the complete VNG test battery (i.e., spontaneous nystagmus, positional testing, tracking, and OPK - the procedures that make up CPT code 92540) but do not perform the OPK for a particular patient, bill the other three codes of the VNG battery individually with a -59 modifier. Audiologists should not report 92540 with a -52 modifier.

Editor's Note: This Ask the Expert was taken from the eSeminar Reimbursement: The 2012 Perspective published on 2/9/2012. To access the recorded course, please go here: www.audiologyonline.com/ceus/recordedcoursedetails.asp?class_id=19955

Robert C. Fifer, Ph.D. is currently the Director of Audiology and Speech-Language Pathology at the Mailman Center for Child Development, Department of Pediatrics, University of Miami School of Medicine. He received his B.S. degree from the University of Nebraska at Omaha in Speech-Language Pathology with a minor in Deaf Education. His M.A. degree is from Central Michigan University in Audiology. And his Ph.D. degree is from Baylor College of Medicine in Audiology and Bioacoustics. Dr. Fifer's clinical and research interests focus on the areas of auditory evoked potentials, central auditory processing, early detection of hearing loss in children, and auditory anatomy and physiology. He is a Past-President of the Florida Association of Speech-Language Pathologists and Audiologists, a member of ASHA's Health Care Economics Committee, and the ASHA representative to the American Medical Association's Health Care Professions Advisory Committee for the Relative Value Utilization Committee in addition to being ASHA's representative to the AMA's Practice Expense Advisory Committee. Additional responsibilities at the state level include serving as a consultant to the Florida Department of Health's Children's Medical Services and the audiology representative to the Genetics and Newborn Screening Advisory Council.