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by | Sep 20, 2022 | Medicare

CPT Code 95992

by | Sep 20, 2022 | Medicare

CPT Code 95992

CPT 95992 – Canalith repositioning procedure(s) (eg, Epley maneuver, Semont maneuver), per day

CPT-Code-95992-National-Government-Services-Medicare

* Source: NGS A56566

Appropriate Diagnosis to Charge CPT Code 95992

  • H81.11 – Benign paroxysmal vertigo, right ear
  • H81.12 – Benign paroxysmal vertigo, left ear
  • H81.13 – Benign paroxysmal vertigo, bilateral
cpt code 95992 Canalith Repositioning

Modifier 59

Below is a screenshot from CMS Practitioner PTP Edits v282r0 (663,766 records) 61000/0213T – U0003/U0004 (ZIP) – Effective July 1, 2022; Posted Aug. 2, 2022

This is a zip file containing a text file and MS Excel spreadsheet with two columns of CPT Codes.

How This Works

Column 1 shows the CPT Code 95992 Canalith repositioning procedure and Column 2 shows other services you may be providing on the same date of service.

If a 1 exists in the 6th column then the coding pair is eligible for the addition of a 59 modifier.

For example, if a physical therapist bills CPT Code 95992 and CPT Code 97110 on the same date of service without adding the 59 modifier to the CPT Code 97110 line item then CPT Code 95992 would pay but CPT Code 97110 would not pay.

Medicare CMS NCCI Edits CPT Code 95992

Coding Pairs Eligible for the 59 Modifier when billed on the same date of service.

CPT Code 95992 CPT Code 97110
CPT Code 95992 CPT Code 97112
CPT Code 95992 CPT Code 97140
CPT Code 95992 CPT Code 97530

How to Correct a Claim

If you make this mistake, the best way to correct the claim is to log into your MAC portal and reopen the claim and add the 59 modifier to the CPT Code 97110 line item. The claim will reprocess and payment will be made.

How to [Reopen] a Medicare Claim | ...
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