• Friday, March 25, 2011RSS Feed

    CMS Instructs Contractors to Pay for Canalith Repositioning Code 95992

    As reported March 11 in News Now, the Centers for Medicare and Medicaid Services (CMS) recently determined that it did not update its "sometimes therapy" list to include the canalith repositioning CPT code for 2011, which led to claim denials for physical therapists (PTs) who submitted for payment using the 95992 code. As promised, the agency has issued a Change Request, with a July 5 implementation date, notifying contractors that they should pay PTs for the 95992 retroactive to January 1. PTs will need to resubmit all claims that have been denied; no automatic adjustments will be made. It is possible that some contractors may be able to update their systems before July 5, so PTs should check with their contractors as to when they can resubmit for payment.


    Comments

    do we have to use any modifiers? if so when?
    Posted by susan mccann on 3/28/2011 7:54 AM
    Similar to other therapy codes that are billed, the GP modifier should be used with CPT code 95992 when provided under a therapy plan of care.
    Posted by News Now on 3/29/2011 1:28 PM
    IF AUDIOLOGIST HAVE THE KNOWLEDGE AND CAN PERFORM CANALITH REPOSITIONING WHY ARE THEY EXCLUDED FROM GETTING PAID. THEY KNOW WHAT TO DO, SOMETIMES BETTER THAN A PT. THIS DOES NOT SEEM FAIR TO THEM OR THE PATIENT
    Posted by ANN on 7/20/2011 3:46 PM
    As a physical therapist who is certified in vestibular rehabilitation and practiced vestibular rehab for nearly 20 years, I believe that any professional provider who is adequately trained should be able to provide and be reimbursed for this service regardless of their credentials, PT, MD, or AUD. While I have met some very qualified audiologists, it should not be assumed that an audiologist or even an ENT would know how to treat the patient most effectively. I have seen poor or inadequate care provided by providers with various credentials; PT, OT, RN, AUD, MD, DC.
    Posted by Robert on 9/14/2011 8:45 AM
    Canalith Repositioning - very good article and I knew not to enter a code to help pay health model?
    Posted by Canalith Repositioning on 2/6/2012 3:52 AM
    Is this code used as an evaluation? Or in conjunction with 97001? Which diagnosis codes can be used with 95992?
    Posted by Ming Lee -> >HScAG on 3/1/2012 11:02 PM
    Am I to understand that payment for 95992 will only be made to PT's as "sometimes therpy" and Never to an MD, NP, or PA if done in office seperately or included in E & M?
    Posted by Denise on 3/7/2012 4:38 PM
    Can only a PT bill for this?
    Posted by Debbie on 1/7/2013 5:06 PM
    doctors are paid too thank you
    Posted by ayad on 3/28/2013 7:54 PM
    we billed 95992 with a 59 modifier and got denied 97112 and 97110. Does anyone know how to bill these correctly? help please.
    Posted by jesse on 5/16/2013 5:25 PM
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