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Dix-Hallpike procedure

Tom Boismier boismier at umich.edu
Thu Jul 3 07:20:56 EST 1997

Jeffrey Sirianni wrote:
> You would think that clinicians with basic equipment, like myself, and
> that the Hallpike Manuever for BPPV has been around so long, that a CPT
> code would be around for billing of this test.  With my equipment, I have
> no other way for testing for BPPV.

The Hallpike maneuver has always been considered part of a group of
'office' tests done by physicians when seeing dizzy patients, and billed
for as part of the office visit. Unfortunately, there is no equivalent
'office visit' code that audiologists/vestibular testing techs could
> Oh, I thought that a new CPT code was available for Vestibular Rehab.  I
> thought I heard that at AAA this year.

I haven't heard of any Oto or audiology codes specifically for VRT, but
codes come and go regularly so we may have missed it. Most new codes
don't get approved for reimbursement by insurance providers for at least
a year after they come out. Usually you have to fight with your
providers to review the code(and re-review...). Some audiologists use
physical therapy codes (97110, 97112, 97116, 97530, 97545 are all
candidates) for VRT. I suspect that that will stop once a few
audiologists get audited by providers, or sued by patients who were
injured during gait training. There is no specific code for VRT in the
physical therapy section either. Some folks simply tell the patient that
insurance doesn't cover VRT, so they'll be billed directly.

(Personal comment mode on...) I think it's perfectly appropriate for
audiologists and vestibular 'scientists' (best name I've heard for a guy
like me...) to perform particle repositioning maneuvers, assess
positional vertigo and hand out habituation exercises. I also think
we're out of our element when it comes to assessing and treating
postural control, gait disturbances, and environmental saftey issues.
For this reason, in our lab we have all VRT patients seen by a physical
therapist. (end personal comment mode... ;)

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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