Clinicians are encouraged to reference their CPT manual for correct code use and to review payer-specific policies when determining appropriate code reporting and documentation requirements for services. Many payer clinical policies will provide criteria for Medical Necessity and will also include procedure and diagnosis codes that will support medical necessity and policies for subsequent reimbursement for services. It is advisable to review payer guidelines and policies prior to billing.
Relevant Procedure Codes
The following CPT codes are available for reporting vestibular and related balance assessments.
Videonystagmography / Electronystagmography
| CPT Code | Description |
| 92540 | Basic Vestibular Evaluation, includes spontaneous nystagmus test with eccentric gaze fixation nystagmus, with recording, positional nystagmus test, minimum of 4 positions, with recording, optokinetic nystagmus test, bidirectional foveal and peripheral stimulation, with recording, and oscillating tracking test, with recording
Do not report 92540 in conjunction with 92270, 92541, 92542, 92544, 92545 |
| 92541 | Spontaneous nystagmus test including gaze and fixation nystagmus, with recording
Do not report 92541 in conjunction with 92270, 92540 or the set of 92542, 92544, and 92545 |
| 92542 | Positional nystagmus test, minimum of four positions, with recording |
| 92544 | Optokinetic nystagmus test, bidirectional foveal or peripheral stimulation, with recording
Do not report 92542 in conjunction with 92270, 92540 or the set of 92541, 92544, and 92545 |
| 92545 | Oscillating tracking test, with recording
Do not report 92545 in conjunction with 92270, 92540 or the set of 92541, 92542, and 92544 |
| 92547 | Use of vertical electrodes
Use 92547 in conjunction with 92540-92546 For unlisted vestibular tests, use 92700 Do not report 92547 in conjunction with 92270 |
Caloric Testing
| CPT Code | Description |
| 92537 | Caloric vestibular test with recording, bilateral; bithermal (ie, one warm and one cool irrigation in each ear for a total of four irrigations)
Do not report 92537 in conjunction with 92270, 92538 For three irrigations, use modifier 52 For monothermal caloric vestibular testing, use 92538 |
| 92538 | Caloric vestibular test with recording, bilateral; monothermal (ie, one irrigation in each ear for a total of two irrigations)
Do not report 92538 in conjunction with 92270, 92537 For one irrigation, use modifier 52 For bilateral, bithermal caloric vestibular testing, use 92537 |
Computerized Dynamic Posturography
| CPT Code | Description |
| 92548 | Computerized dynamic posturography sensory organization test (CDP-SOT), six conditions (eyes open, eyes closed, visual sway, platform sway, eyes closed platform sway, platform and visual sway), including interpretation and report.
Do not report 92548, 92549 in conjunction with 92270 |
| 92549 | Computerized dynamic posturography sensory organization test (CDP- SOT), six conditions (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).
Do not report 92548, 92549 in conjunction with 92270 |
Vestibular Evoked Myogenic Potential (VEMP) Testing
| CPT Code | Description |
| 92517 | Vestibular evoked myogenic potential (VEMP) testing, with interpretation and report; cervical (cVEMP)
Do not report 92517 in conjunction with 92270, 92518, 92519 |
| 92518 | Vestibular evoked myogenic potential (VEMP) testing, with interpretation and report; ocular (oVEMP)
Do not report 92518 in conjunction with 92270, 92517, 92519 |
| 92519 | Vestibular evoked myogenic potential (VEMP) testing, with interpretation and report; cervical (cVEMP) and ocular (oVEMP)
Do not report 92519 in conjunction with 92270, 92517, 92518 |
Rotational Testing
| CPT Code | Description |
| 92546 | Sinusoidal vertical axis rotational testing
Do not report 92546 in conjunction with 92270 |
Electrocochleography
| CPT Code | Description |
| 92584 | Electrocochleography, with interpretation and report |
Medicare Coverage Policies for Vestibular Assessment and Treatment
Medicare provides coverage for vestibular assessment and evaluation when medically necessary but does not cover treatment or management options for vestibular or balance-related issues when performed by audiologists. Most commonly, treatment or management options would include canalith repositioning procedures and vestibular rehabilitation therapy. These non-covered services should not be billed to Medicare when performed by audiologists. If claims need to be submitted for denial (e.g., for coordination with a secondary insurance plan) or if the patient requests that the claim be submitted to Medicare, the -GY modifier (Item or service statutorily excluded, does not meet the definition of any Medicare benefit) must be used with any codes for these non-covered services and/or devices. Additional information on Medicare coverage policies for audiologic procedures can be found here.
Frequently Asked Questions
- What component procedures are required when reporting 92540 (Basic Vestibular Evaluation) since it is a bundled code?
- How many positions are required to report 92542 (Positional nystagmus test) as part of the 92540 (Basic Vestibular Evaluation)?
- Since saccades (and by extension anti-saccades) are not included as part of the 92540 (Basic Vestibular Evaluation) code, how do I report those services?
- How do report incomplete ENG/VNG testing when not all of the bundled components were performed as part of 92540 (basic vestibular evaluation)?
- Can I report 92547 (use of vertical electrodes) when performing videonystagmography using infrared goggles?
- What code is most appropriate to report when performing a Dix-Hallpike procedure?
- What is the proper coding for an Epley/Semont procedure? Is this the same code for any canalith repositioning maneuver (e.g., barbeque roll, Yacovino maneuver, etc.)?
- What is the proper coding for caloric testing procedures?
- How do I report caloric testing when all testing conditions were not able to be obtained?
- What is the proper coding for computerized dynamic posturography testing procedures?
- Is this service typically covered and is any additional documentation required when performed?
- How do I report VEMPs when only performed on one ear?
- What rotational testing procedures are included in 92546 (sinusoidal vertical axis rotational testing)?
- Is there a minimum number of rotational testing frequencies or test conditions to report 92546?
- Are there insurance/payer minimum requirements for rotational chairs?
- Can I report 92546 (sinusoidal vertical axis rotational testing) for headshake testing?
- Should I report 92546 (sinusoidal vertical axis rotational testing) for VOR Suppression testing?
- How do I report vestibular assessment procedures that do not have a CPT code?
- Are there CPT codes that are available to report vestibular screening procedures?
Need more help?
Contact us at reimbursement@audiology.org.
*CPT codes, descriptions, and other data are Copyright 1966, 1970, 1973, 1977, 1981, 1983–2025 American Medical Association. All rights reserved. CPT© is a registered trademark of the American Medical Association.
Disclaimer
The purpose of the information provided by the American Academy of Audiology Coding and Reimbursement Committee is strictly for educational guidance to audiologists. Action taken with respect to the information provided is an individual choice. The American Academy of Audiology hereby disclaims any responsibility for the consequences of any action(s) taken by any individual(s) as a result of using the information provided, and reader agrees not to take action against, or seek to hold, or hold liable, the American Academy of Audiology for the reader's use of the information provided. As used herein, the "American Academy of Audiology" shall be defined to include its directors, officers, employees, volunteers, members, and agents.
