Dix-Hallpike procedure

Tom Boismier boismier at umich.edu
Mon Jun 30 08:42:16 EST 1997


Jeffrey Sirianni wrote:
 
> The original post implied that the Dix-Hallpike procedure was catagorized
> in the CPT realm as a caloric test (which it is not).  So I asked if one
> can bill the caloric CPT code twice, one for binaural, bithermal irrigation
> with recording AND again for performing thr Dix-Hallpike Manuever.  You say
> that there is no CPT code for the Dix-Hallpike Manuever, so how does one
> bill for it, or is it a test you do and eat the charge?

Ahh, we *were* talking about the Hallpike maneuver to start! I'll bet
the CPT code poster was just confused about semantics, as I was.
"Dix-Hallpike procedure" was an early term for calorics with
observation. Dr. Hallpike came up with lost of useful tests...

Yes, we do the Hallpike maneuver and don't charge specifically for it.
It's part of a whole host of subtests that we do do as part of an ENG
battery which don't have CPT codes, like saccade (the 92546 code is for
pursuit only), Fukuda stepping, ocsillopsia, and postural control tests
like Romberg and CTSIB. The trick is to set you charges for what you
*can* bill for high enough to cover all the subtests you need to do in
order to provide adequate diagnostic information. 

It just demonstrates that CPT coding is a mess. We can't wait around for
a CPT code to come out before doing appropriate tests and procedures. It
took 12 years to get a code # for Dynamic Posturography, and most
insurers don't accept it anyway. The CPT code used for rotary chair is
actually a code for "Torsion Swing" test, which you can't even buy
anymore. The code assigned to rotary chair was *never* accepted by
insurers, so labs went back to using the old torsion swing code in order
to get paid. There is no CPT or ICD-9 code for vestibular rehab either,
you just have to dig through the book until you find one that seems to
fit that you can get paid for in your area. Onward and upward...

-- 
Thomas E. Boismier, MPH <boismier at nospam.umich.edu>
Associate Director, Vestibular Testing Center
Department of Otorhinolaryngology
University of Michigan Hospitals

[Remove "nospam." from the above address to email me]



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