Physical therapists (PTs) who have been denied payment when using the canalith repositioning CPT code 95992 will have to resubmit claims after the Centers for Medicaid and Medicare Services' (CMS) contractors update their systems.
CMS recently determined that it did not update its "sometimes therapy" list to add the canalith repositioning code for 2011. As a result, contractors were denying payment. CMS will be issuing a Change Request in about 2 weeks that will update the "sometimes therapy" list notifying contractors that they should pay physical therapists for the 95992 code. Payment will be made retroactive to January 1. However, CMS states that the contractors may not be able to update their systems to pay for the code until July 1. PTs will need to resubmit all claims that are denied after the contractors update their systems. There will not be automatic adjustments. It is possible that some contractors may figure out a way to pay before July 1, so providers should check with their contractors after the change request is issued.