About this policy
CMS National Coverage Determination | ncd_id=5 | manual_section=50.8 | coverage_level_code=3 | national_coverage_type=True | under_review=False | lab_ncd=False
Documentation requirements
Item/Service Description: Reimbursement may be made for ultrasonic surgery when required in the treatment of patients with severe and recurrent episodes of vertigo due to Meniere's syndrome. This procedure utilizes a machine that produces ultrasonic waves of high intensity and frequency that selectively irradiate certain portions of the inner ear thereby destroying the tissue. The procedure is usually done under local anesthesia, and requires the services of a surgeon and another individual who is responsible for calibrating the electrical equipment, and who assists in observing certain physical changes (e.g., movement of the eyes, "nystagmus") indicative of inner ear reaction to the ultrasonic destruction. Except in rare instances the desired result is achieved with one treatment. At present, there are two different approaches being used to apply the ultrasound to the inner ear: one through the lateral semicircular canal and, more recently, a simpler approach from a technical viewpoint, through the round window. Benefit Categories: 52 - Physicians' Services
Codes in this policy
Code numbers and each code’s status as the policy records it. CPT code descriptions are left out of this page, as are the passages that cite CPT codes; the official document has them.
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