Medicare Vestibular Testing Payment Restrictions Will be Lifted on October 1
Audiologists, otolaryngologists, and neurologists gained a victory yesterday after months of lobbying to get erroneous coding edits revised. The Centers for Medicare and Medicaid Services (CMS) will correct the National Correct Coding Initiative (NCCI) edits effective October 1, 2010, related to vestibular testing codes 92541, 92542, 92544, and 92545. The CCI edits will allow Medicare billing of combinations of 3 or less of codes 92541, 92542, 92544, and 92545. CMS wrote that, “If two or three of these codes are reported for the same date of service by the same provider for the same beneficiary, an NCCI-associated modifier may be utilized to bypass the NCCI edits.” ASHA is seeking clarification about the practitioners and the outpatient facilities edits and their specific modifications. It seems clear that the practitioners revision will become effective on October 1, 2010, but it is not as clear for the outpatient facilities. We are also requesting clarification regarding the correct NCCI-modifier to use when reporting the codes to Medicare.
from ASHA’s Notes