How Does A Medical Billing Outsourcing Company Code Vertigo And Its Treatments?

by | Posted: Feb 22, 2022 | Medical Coding

Vertigo is a sensation of feeling off balance that often comes with symptoms such as vomiting, headache, sweating, spinning, going unbalanced, or pulled to one direction. Even though the main cause of the condition is related to issues with the inner ear balance, it can also be triggered by certain head movements or benign paroxysmal positional vertigo (BPPV), migraines, inner ear infection (labyrinthitis) or inflammation of the vestibular nerve (vestibular neuronitis). Otolaryngologists and neurologists can ensure accurate medical coding for vertigo on their medical claims with the support of an experienced medical coding company.

ICD-10 Codes to Indicate a Diagnosis of Vertigo

  • A88.1 Epidemic vertigo
  • H81.10 Benign paroxysmal vertigo unspecified ear
  • H81.11 Benign paroxysmal vertigo right ear
  • H81.12 Benign paroxysmal vertigo left ear
  • H81.13 Benign paroxysmal vertigo bilateral
  • H81.20 Vestibular neuritis unspecified ear
  • H81.21 Vestibular neuronitis right ear
  • H81.22 Vestibular neuronitis left ear
  • H81.23 Vestibular neuritis bilateral
  • H81.31 Aural vertigo
    • H81.311 Other peripheral vertigo right ear
    • H81.312 Other peripheral vertigo left ear
    • H81.313 Other peripheral vertigo bilateral
    • H81.319 Other peripheral vertigo unspecified ear
    • H81.391 Other peripheral vertigo right ear
    • H81.392 Other peripheral vertigo left ear
    • H81.393 Other peripheral vertigo bilateral
    • H81.399 Other peripheral vertigo unspecified ear
  • H81.4 Vertigo of central origin
  • H81.8 Other disorders of vestibular function
    • H81.8X Other disorders of vestibular function
    • H81.8X1 …… right ear
    • H81.8X2 …… left ear
    • H81.8X3 …… bilateral
    • H81.8X9 …… unspecified ear
    • H81.91 Unspecified disorder of vestibular function, right ear
    • H81.92 Unspecified disorder of vestibular function, left ear
    • H81.93 Unspecified disorder of vestibular function, bilateral
  • R42 Dizziness and giddiness
    • T75.23XA Vertigo from infrasound initial encounter
    • T75.23XD Vertigo from infrasound subsequent encounter
    • T75.23XS Vertigo from infrasound sequela

    ICD-10 Codes to Indicate Diagnostic Studies for Vertigo

    Along with physical examination, other tests used to diagnose the condition include hearing tests done by an ENT specialist such as audiometry test, tuning fork test, videonystagmography, caloric testing, dynamic or static platform posturography, and CT or MRI scan of head.

    • Z01.1 Encounter for examination of ears and hearing
      • Z01.10 …… without abnormal findings
      • Z01.11 Encounter for examination of ears and hearing with abnormal findings
      • Z01.110 Encounter for hearing examination following failed hearing screening
      • Z01.118 Encounter for examination of ears and hearing with other abnormal findings
      • Z01.12 Encounter for hearing conservation and treatment
    • R94.12 Abnormal results of function studies of ear and other special senses
      • R94.120 Abnormal auditory function study
      • R94.121 Abnormal vestibular function study
      • R94.128 Abnormal results of other function studies of ear and other special senses

    CPT Procedure Codes

    • 92517 Vestibular evoked myogenic potential (VEMP) testing, with interpretation and report; cervical (cVEMP)
    • 92518 Vestibular evoked myogenic potential (VEMP) testing, with interpretation and report; ocular (oVEMP)
    • 92519 Vestibular evoked myogenic potential (VEMP) testing, with interpretation and report; cervical (cVEMP) and ocular (oVEMP)
    • 92537 Caloric vestibular test with recording, bilateral; bithermal (i.e., one warm and one cool irrigation in each ear for a total of four irrigations)
    • 92538 Caloric vestibular test with recording, bilateral; monothermal (i.e., one irrigation in each ear for a total of two irrigations)
    • 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
    • 92541 Spontaneous nystagmus test, including gaze and fixation nystagmus, with recording
    • 92542 Positional nystagmus test, minimum of 4 positions, with recording
    • 92544 Optokinetic nystagmus test, bidirectional, foveal or peripheral stimulation, with recording
    • 92545 Oscillating tracking test, with recording
    • 92546 Sinusoidal vertical axis rotational testing
    • 92547 Use of vertical electrodes (list separately in addition to code for primary procedure)
    • 92548 Computerized dynamic posturography sensory organization test (CDP-SOT), 6 conditions (i.e., eyes open, eyes closed, visual sway, platform sway, eyes closed platform sway, platform and visual sway), including interpretation and report
    • 92549 Computerized dynamic posturography sensory organization test (CDP-SOT), 6 conditions (i.e., 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)
    • 92552 Pure tone audiometry (threshold); air only
    • 92553 Pure tone audiometry (threshold); air and bone
    • 92556 Speech audiometry threshold; with speech recognition
    • 92557 Comprehensive audiometry threshold evaluation and speech recognition (92553 and 92556 combined)

    Some of the effective treatments recommended to treat vertigo symptoms include Epley maneuver, and vestibular rehabilitation training (VRT). Medications such as prochlorperazine and certain antihistamines may be recommended in the early stages of vertigo. In rare cases, surgery may be needed.

    ENT specialists, neurologists and other specialists treating vertigo conditions can consider hiring professional medical coding services to ensure accurate medical coding and prevent claim denials.

Rajeev Rajagopal

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