Note: CPT codes 92537 and 92538 may not be billed more than once on the same date of service. To report more irrigations than indicated in each code, consider using the modifier -22 to indicate an increased service. In those circumstances, clinicians should be prepared to provide justification for the increased service and why it was needed.

92540 - Basic vestibular evaluation, includes the following.

1. Spontaneous nystagmus test with eccentric gaze fixation nystagmus, with recording.
2. Positional nystagmus test, minimum of 4 positions, with recording.
3. Optokinetic nystagmus test, bidirectional foveal and peripheral stimulation, with recording.
4. Oscillating tracking test, with recording.

92541 -  Spontaneous nystagmus test, including gaze and fixation nystagmus, with recording.

These nystagmus tests document and measure the inability of the eyes to maintain a static position as a result of peripheral, CNS or congenital abnormality.

92542 -  Positional nystagmus test, minimum of four positions, with recording.

These spontaneous nystagmus tests document and measure the inability of the eyes to maintain a static position when the head is in different positions. These tests are valuable in documenting and quantifying patient complaints of dizziness in certain situations or positions. Moreover, they are sometimes helpful in localizing the abnormality as CNS or peripheral.

The caloric tests evaluate the viability of the peripheral end organs by stimulating them with warm and cold water or air while the patient is in the dark. The resulting dizziness and nystagmus is taken as an index of the viability of the organ. This helps in evaluating the ability of the CNS to visually suppress inappropriate dizziness and nystagmus.

The optokinetic test documents and measures eye movements as the patients watches a series of targets moving simultaneously to the right and then to the left. The optokinetic mechanism is at work when the visual movement in one direction encompasses more than a single point.

The smooth pursuit test evaluates the ability of the patient to keep a moving visual target registered on the fovea. The patient watches a moving target as it moves back and forth in a smooth pendular fashion. The saccadic test evaluates the ability of the patient to find a moving target and tests certain CNS neural integrators.

This is a computerized test of the Vestibulo-Ocular Reflex (VOR), the neural mechanism that keeps a visual image registered on the fovea during head movement. It evaluates the three functional components of the VOR system: the peripheral end organ, the vestibular nuclei of the brain stem and the higher central vestibular connections. The test is accomplished by having the patient move their head in both the horizontal and vertical plane. This information is useful for evaluating patients with balance disorders.

92548 - Computerized Posturography

97750 -  Physical performance test or measurement, with written report

95992 - Canalith repositioning procedure, performed by therapy personnel, under a therapy plan of care, (usually performed by a physical therapist)

97110 -  Therapeutic procedure, 1 or more areas, each 15 minutes, therapeutic exercises to develop strength, endurance, range of motion and flexibility.

97112 -  Neuromuscular reeducation of movement, balance, coordination, kinesthetic sense, posture, and proprioception, each 15 minutes

97116 -  Therapeutic procedure, 1 or more areas, each 15 minutes; gait training (includes stair climbing), each 15 minutes

97140 -  Manual therapy techniques, 1 or more regions, each 15 minutes