Academy Letter to Palmetto GBA: CPT 92557 Should Be Covered

Academy Letter to Palmetto GBA: CPT 92557 Should Be Covered

The Academy recently wrote to Palmetto GBA, a Medicare Administrative Contractor, to express concerns regarding the Palmetto policy for reimbursement of tests on the same day a vestibular function study is performed.  

Specifically, Palmetto stated that only CPT 92552 (pure-tone audiometry threshold; air only) or CPT 92553 (air and bone) will be covered on the same day as a vestibular function study, but not CPT 92557 (comprehensive audiometry threshold evaluation and speech recognition). We argued that CPT 92557 should be covered.

In response to the Academy's letter, Palmetto has now determined that CPT 92557 may indeed be reimbursed when performed on the same day as a vestibular function study. CPT 92557 could be performed, instead of CPT 92553, when the speech-recognition component of CPT 92557 is reasonable and necessary in the diagnosis or treatment of an individual Medicare beneficiary (e.g. vestibular schwannoma).

These changes will be communicated in a revised Billing and Coding Article: Vestibular Function Testing (A56497)

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