Billing and Coding: Vestibular Function Testing

Vestibular function testing is covered when medically necessary with appropriate ICD‑10‑CM documentation and when performed or supervised by authorized providers per scope‑of‑practice and CFR requirements. Specific CPT codes have defined billing rules and frequency limits (e.g., CPT 92542 requires four or more positions and CPTs 92542/92544/92545/92546/92548 are billable once per day; CPT 92537/92538 have defined irrigation reporting and modifier 52 rules). Claims lacking documented diagnosis/clinical suspicion, routine repeat testing without symptom recurrence, CPT 92531-92534 (not payable), or improper concurrent billing (e.g., CPT 92557 with 92553/92556) will be denied or are restricted.

"Vestibular diagnostic procedures (CPT 92541-92542, 92544-92548) are covered when an appropriate ICD-10-CM diagnosis or clinical suspicion for vestibular dysfunction is documented in the medical rec..."