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NEW AND NOTEWORTHY

Clinical Practice Guidelines Summary.

Click HERE for the Summary of the articles.

Barany Society Lectures

The Journal of Vestibular Research has posted lectures from the Barany Society meeting that was held in South Korea. The lectures are by Drs. Staab, Strupp, KIngma, Halmagi, and Maggnusson. Bárány Society YouTube Videos The speakers are world-renowned and they are FREE.

 

What's new with Podcasts?

Rachel Trommelen has stepped down as the Podcast chair and Maureen Clancy has taken over.  With this change the new podcasts are being produced through the blogtalkradio.com site.  Please checkout the new podcasts here.  


What is Vestibular Rehabilitation? 

Click HERE as described by Sara Oxborough.

Vestibular CPG has been published!

The Academy of Neurologic Physical Therapy of the APTA supports the development of evidence-based clinical practice guidelines (CPG) to assist physical therapists with the treatment of persons with peripheral vestibular hypofunction in order to optimize rehabilitation outcomes. The purpose of this CPG for peripheral vestibular hypofunction is to describe the evidence supporting vestibular physical therapy including interventions and discharge planning supported by current best evidence.

You can find the full document here.

Additional resources:

Description of Vestibular CPG

One page summary for physical therapists

One page summary for physicians

Coding Challenge

Lisa Dransfield, PT DPT MA

When Canalith Re-positioning (CPT Code 95992) is denied by a payer for reimbursement, a number of factors must be considered to determine the reason.  The practice setting and state in which the service is delivered affects reimbursement.  Fee schedules also vary among states; for example, an outpatient clinic in Texas that provides both audiology and physical therapy, tracked the usage and reimbursement of the code in 2014. The code was billed 600 times with an average reimbursement of $33.33. In an outpatient multidisciplinary vestibular clinic in Connecticut, the code was billed 759 times in 2014, for an average reimbursement of $48.36.

Reportedly, Medicare in Georgia does not pay for Canalith Re-positioning; whereas, Medicare in Connecticut does, at a rate of $36.78.  In Connecticut, as in 9 other states, Medicare is administered by the National Government Services (processes approximately 20 percent of the nation's Medicare Claims) and proper billing is mandatory for timely reimbursement of CPT 95992. It must be linked with a diagnosis of BPPV and if additional procedural codes are used in the same treatment, a modifier may need to be added to the additional code.

Reference:  http://www.ngsservices.com/claims.html

For more information on payment, visit our Payment Policy – Medicare G codes, BPPV CPT code tab

PPPD or triple P-D Research Update:

Many of you have been asking us about a newly defined vestibular condition called "Persistent Postural-Perceptual Dizziness" (or "triple P-D"), previously referred to as Chronic Subjective Dizziness (CSD). With the help of Dr. Jeffrey Staab VEDA has put together a short publication to educate patients about this disorder.

In 1986, German neurologists Thomas Brandt and Marianne Dieterich first described a condition that they called phobic postural vertigo (PPV). Symptoms included postural dizziness without vertigo and fluctuating unsteadiness provoked by environmental or social stimuli (e.g. crowds), which could not be explained by some other neuro-otologic disorder. Triggers included a pre-existing vestibular disorder, medical illness or psychological stress.

Behavioral criteria of PPV included the presence of an obsessive-compulsive personality, mild depression, and anxiety. Studies on PPV showed that it was NOT a psychiatric disorder, but rather a neuro-otologic condition with behavioral elements.

In the early 2000s, the American team of Jeffrey Staab, Michael Ruckenstein, & their colleagues performed studies to update the concept of PPV and described the clinical syndrome of chronic subjective dizziness (CSD).  The symptoms of CSD included non-vertiginous dizziness and unsteadiness that was increased by a person’s own motion, exposure to environments with a complex or moving stimuli (e.g., stores, crowds), and performance of tasks that required precise visual focus (e.g., reading, using a computer).

Other vestibular experts described space-motion discomfort and visual vertigo, symptoms that overlapped to some extent with PPV and CSD.

In 2010, scientists from around the world began a process of identifying the most important features of these syndromes.  In early 2014, they reached a consensus on the key symptoms and defined a diagnosis of Persistent Postural-Perceptual Dizziness (PPPD).

To read more about PPPD, visit VEDAs website at https://vestibular.org/pppd.

We need your help!!

The Vestibular Rehabilitation SIG needs a few volunteers to help!  Below is a list of areas of opportunities to serve:

1) PodCast committee:  Rachel Trommelen is looking for someone to help her facilitate and produce the Podcasts.  

2) Patient and Physician Fact Sheet Committee is looking for help to update information.

Please contact Anne Galgon for more information on these opportunities!!

 

Other Announcements

  • The Patient Fact sheets have been updated!
  • There is a new offering for the Patient Education Fact Sheets:  Navajo language podcasts!  The first one, "What is BPPV?", is on the page, with more to follow. See the Patient Education Fact Sheets Tab. Thank you to Selena Bobula, PT, DPT for this important contribution!
  • Medicare G Code information is available on the "Payment Policy" page- thanks to Kenda Fuller for your hard work in preparing these materials!
  • Jeff Walter, PT, DPT, NCS has provided us with a link to a page on his website, www.vestibularseminars.com, which has VIDEOS of exam techniques and other helpful resources.  Thanks, Jeff!  The link will also be on the resources page. 

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    The Vestibular Rehab SIG has it's own Facebook page- "like" us now!         

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    The Vestibular Rehab SIG has it's own Twitter page

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