CMS Issues Clarification for Billing Canalith Repositioning Procedures
CMS issued a transmittal and MLN Matters article providing guidance for SNF and therapy billing, including how to bill for Canalith repositioning procedures. These clarifications indicate that effective January 1, 2009, the new Current Procedural Terminology (CPT) code 95992 (Canalith repositioning procedure(s) (eg Epley maneuver, Semont maneuver), per Day) is bundled under the Medicare Physician Fee Schedule (MPFS). Regardless of whether CPT code 95992 is billed alone or in conjunction with another therapy code, separate Medicare payment is never made for this code. If billed alone, this code will be denied. On remittance advice notices for claims so denied, Medicare contractors will use group code CO and claim adjustment reason code 97 (“Payment is included in the allowance for another service/procedure.”). Alternatively, reason code B15, which has the same intent, may also be used by your Medicare contractor.