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Question: What is the correct CPT^脪 code for the video head impulse test (vHIT), which is a vestibular audiology test?

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Answer: When a patient reports to your office complaining of vertigo, dizziness or balance problems, the otolaryngologist may order a vHIT. The test employs a video camera to track small, almost imperceptible movements in the patient鈥檚 eyes while their head is moved into various positions. Those eye movements, known as catch-up saccades, enable the eyes to continue focusing on distant objects; any impairment in that ability to focus can lead to the patient experiencing the conditions mentioned above.

Unfortunately, there is no CPT^脪 code for vHIT. This means you should use an unlisted code, which in this case would be 92700 (Unlisted otorhinolaryngological service or procedure).

Remember: The instructions in the introduction to the CPT^脪 code book tell you when you cannot 鈥渟elect the CPT code of the procedure or service that accurately identifies the procedure or service performed鈥� to 鈥渞eport the procedure or service using the appropriate unlisted procedure or service code.鈥� This means 鈥渁dequately and accurately鈥� documenting 鈥渁ny modifying or extenuating circumstances 鈥� in the medical record.鈥�

Here鈥檚 why: 鈥淏ecause unlisted codes are manually reviewed,鈥� this documentation 鈥渨ill help you be as much help as you can to the reviewer,鈥� according to Jill Young, CPC, CEDC, CIMC, owner of Young Medical Consulting in East Lansing, Michigan.

In addition to that documentation, you should also provide a comparison code for the reviewer. 鈥淭his way, there is not only something to compare the unlisted work to, but there is an additional reference with an estimate of how much work, comparatively, the remainder of the procedure was. The fee should reflect this percentage increase,鈥� explains Young.

For vHIT procedures, a good comparison code is 92542 (Positional nystagmus test, minimum of 4 positions, with recording). This is another positional test that measures the rapid movement of the patient鈥檚 eyes while their head is rotated. For comparison, Medicare currently values the work relative value units (RVUs) involved in 92542 at 0.48, the practice expense RVU at 0.36, and the malpractice RVU at 0.86. This leads to a Medicare valuation of $27.82 for 92542 at the 2025 national nonfacilty rate.

Bruce Pegg, BA, MA, CPC, CFPC, Managing Editor, AAPC