The patient journey for vestibular assessment can be a lengthy process. A 2011 survey by the Vestibular Disorders Association (VEDA) states that, on average, patients consult four to five doctors before receiving a diagnosis. Furthermore, it takes an average of three to five years for a person with a vestibular disorder to receive a diagnosis (VEDA, 2011). By applying new testing techniques, clinicians can scale down their workflow and obtain an accurate diagnosis in less time.
Topic(s): Encephalopathy, vestibular schwannoma, vestibular migraine (VM), Vestibular, vestibular evaluation
Dizziness and imbalance are complex and, often, multifactorial conditions that require skilled evaluation, sometimes by multiple health-care providers.
As audiologists, our role is largely diagnostic in nature. We are able to perform a variety of tests to help identify or rule out the site of lesion. Working in a collaborative team with physical therapists who are specifically trained in vestibular rehabilitation provides a comprehensive and dynamic approach to treating these patients.
Topic(s): vestibular evaluation, vestibular disorders, therapy
The standard electronystagmography/videonystagmography (ENG/VNG) exam, first described 80 years ago, has been around for about 60 years. The recording techniques have improved, but the tests are the same. Our understanding of vestibular function and methods to evaluate the vestibular ocular reflex (VOR) also have improved, but our profession still relies primarily on VNG testing to determine vestibular function. Let’s take a critical look at this standard of care.
Topic(s): vestibular disorders, vestibular evaluation, Vertigo, vng, videonystagmography
The vestibular evaluation can include a number of different procedures, and coding for these evaluations can often be confusing. There are several current procedural terminology (CPT®) codes that should be considered when completing your evaluation.
Topic(s): Coding, Reimbursement, Balance/Vestibular, Audio-vestibular/Audiovestibular, vestibular evaluation, dix-hallpike maneuver, positional nystagmus test, caloric irrigation, cervical vestibular-evoked myogenic potential (cVEMP), optokinetic nystagmus test, oscillating tracking test, spontaneous nystagmus test, sinusoidal vertical axis rotation testing, computerized dynamic posturography
On November 2, 2017, the Centers for Medicare & Medicaid Services (CMS) released the Medicare Physician Fee Schedule (MPFS) final rule for 2018.The final rule addresses adjustments to the MPFS and other Medicare Part B payment policies, including changes in valuation for services and overall payment updates.
Topic(s): Coding, Reimbursement, vestibular evaluation, vestibular disorders, Centers for Medicare and Medicaid Services (CMS), Medicare Physician Fee Schedule (MPFS), Medicare, CPT - Current Procedural Terminology, Children's Health Insurance Program (CHIP), Medicare Access and CHIP Reauthorization Act (MACRA), Achieving a Better Life Experience (ABLE), American Medical Association (AMA), Relative Value Scale Update Committee (RUC), Physician Quality Reporting System (PQRS), Outpatient Prospective Payment System (OPPS), Quality Payment Program (QPP), Healthcare Common Procedure Coding System (HCPCS)