Two references that work as a pair. The ICD-10 guide answers which diagnosis; the CPT guide answers which procedure code, and how to report it. Each points to the other where the question crosses over.

ICD-10-CM Coding Reference

Vestibular, concussion, balance & dizziness conditions

A comprehensive ICD-10-CM reference organized by code category, built for rapid lookup during documentation and to support medical necessity language — with a rehab-focused lens on which diagnosis leads the claim and how codes pair with your CPT codes and goals.

ICD-10-CM Content includes:

• Impairment codes used by rehab therapists — why the impairment you treated usually leads the claim, why that's a scope principle rather than a sequencing rule, when a confirmed medical diagnosis leads instead, and how to avoid redundant double-coding.

• H81 — disorders of vestibular function — BPPV with full laterality guidance (including when H81.10 is and isn't enough), Ménière's, vestibular neuronitis, aural vertigo, other peripheral vertigo, and vertigo of central origin, with a note on the laterality subcodes deleted in FY2020 that online lookups still display.

• H83 — other diseases of inner ear — labyrinthitis, labyrinthine fistula, and labyrinthine dysfunction, with a note on why these families aren't interchangeable.

• R-codes — dizziness/giddiness, unsteadiness, gait abnormalities, abnormal posture, ataxia, repeated falls, fatigue.

• G-codes — migraine variants including the preferred vestibular migraine approach, vascular headache, hereditary ataxia, autonomic dysfunction, polyneuropathy.

• F-codes — PPPD, generalized anxiety, panic disorder, phobias, depression, postconcussional syndrome.

• S-codes — concussion with and without LOC, traumatic ear drum rupture, acoustic nerve injury, with 7th-character guidance.

• Other commonly used codes — muscle weakness, history of falling, hearing loss including ototoxic, tinnitus including pulsatile, hyperacusis, orthostatic hypotension, cervicogenic codes.

Quick reference table: twelve common vestibular diagnoses with their medical diagnosis codes and key diagnostic features.

CPT pairing guidance: a curated set of the vestibular and balance codes most often reported (evaluations, 97110, 97112, 97116, 97140, 97530, 97533, 97535, 97750, 95992) mapped to the impairments they support, so diagnosis, CPT, and goals describe the same clinical work.

CPT 95992 — diagnosis linkage: why some payers deny canalith repositioning outright without a BPPV diagnosis attached, which codes reliably support the claim, and why adding R42 to a confirmed BPPV claim can cost you the payment.

Documentation principles: coding to highest specificity, documenting laterality, coding what you evaluated and treated rather than rule-outs, using secondary codes for comorbidities, and avoiding double-coding once a diagnosis is established.

Notes worth reading twice: PPPD has no dedicated ICD-10-CM code — F45.8 is the convention, with Bárány Society context on why that placement is a limitation of the code set rather than a statement about etiology. The guide also flags the vestibular migraine coding myths, including the menstrual migraine codes some billing sites incorrectly recommend.

Best used for: documentation support during SOAP note completion · laterality coding · sequencing treatment versus medical diagnoses · pairing diagnoses with CPT codes to support medical necessity · selecting secondary diagnoses · quick reference during assessment write-up.

CPT Code Quick Reference Guide

Vestibular rehabilitation and balance therapy

A comprehensive ICD-10-CM reference organized by code category, built for rapid lookup during documentation and to support medical necessity language — with a rehab-focused lens on which diagnosis leads the claim and how codes pair with your CPT codes and goals.

CPT Code Content includes:

• Therapeutic intervention codes (time-based) — 97110, 97112, 97116, 97140, 97530, 97533, 97535, each with its vestibular application, plus what to confirm with each payer about the 8-minute rule.

• Sensory reweighting and CPT 97533 — why the code that appears to name your sensory reorganization work was built around a different construct, where commercial payers and Medicare diverge, and how to decide between 97112 and 97533 for the same session.

• Canalith repositioning — CPT 95992 — untimed once-per-day reporting and what per day actually means, which services it absorbs, NCCI modifier requirements, BPPV diagnosis linkage, frequency expectations, and what to do when a payer doesn't cover it.

• Evaluation and re-evaluation codes (PT & OT) — 97161–97164 and 97165–97168 with full required components: element counts, personal factors and comorbidities, presentation stability, performance deficits, decision-making complexity — and how to select a level without guessing.

• Additional applicable codes — 97150 group therapy, 97750 physical performance testing, 97755 assistive technology, 97129/97130 cognitive intervention, 96110 developmental screening.

• Therapy modifiers — GP and GO discipline modifiers, CQ and CO assistant modifiers, the KX threshold modifier.

• Vestibular diagnostic codes (awareness reference) — caloric testing, basic vestibular evaluation, VNG/ENG components, rotary chair, and computerized dynamic posturography, with guidance on when CDP falls within therapy scope.

Questions this guide answers: Which CPT code do I use for the Epley maneuver? Can I bill canalith repositioning and gaze stabilization on the same day? Is 95992 timed or untimed? How do I choose between 97161, 97162, and 97163? What are elements, and how do I count them? Should I bill 97533 or 97112 for sensory reorganization work? Why do payers call sensory integration investigational when sensory reweighting is well established? What does my note need to say if I report 97533? Do I need a modifier when my PTA treats? Does the 8-minute rule apply to all payers? Should I bill 97750 or the specific posturography code? Why does 92547 appear on some reports and not others? What do I do when my payer won't cover a code I performed?

A note on scope

Both guides are clinical education resources written by a physical therapist, not a certified professional coder. Code sets update annually and payer policies vary — verify against current official sources and your own billing specialist. What these guides teach is how to think about code selection so your documentation, your diagnosis, and your billing describe the same clinical work.

Disclaimer: For informational purposes only. Always verify current codes and payer policies with official sources. These resources are included in the VestibularSOAP Pro Course & Resources and Vestibular Visionaries Network. If you're already have access to this course and/or are a member, check your resource library before purchasing.

After purchase, you'll receive a file with a link to create your 360NeuroGO account — that's where you'll access this resource. Please note: this resource is included in the Assessment & Documentation Bundle (on sale for 19 (regular price $67).

⬇️⬇️⬇️⬇️⬇️

🌟 This resource is also included with the VestibularSOAP Pro On-Demand Course. Enroll today and get this resource plus:

Education Videos and Demo Videos:

• 📋 Subjective — Master the patient intake that creates trust and asks targeted questions to unlock diagnostic clarity
• 🔍 Objective — Learn which specific findings reveal underlying pathology and define your evaluation
• 🧩 Assessment — Develop pattern recognition that drives differential diagnosis and targeted care planning
• ⚡ Plan — Create treatment rationales that match patient presentations for customized therapy
• 💬 Live Q&A — Get your clinical reasoning questions answered in real time

Resource Library:

• Health History Questionnaire for Vestibular Evaluation - Comprehensive 30-minute pre-visit intake capturing medical, medication, sleep, mental health, and symptom history
• TiTrATE Quick Reference - Timing, Triggers & Targeted Exams — evidence-based triage framework for acute and urgent vertigo presentations
• SO STONED Quick Reference - 8-dimension systematic symptom framework for comprehensive outpatient vestibular interviews (Wuyts et al.) 
• Objective Clinical Vestibular Examination Template - Comprehensive, systematic bedside examination framework — seated → standing → dynamic → positional progression
• Age-Based Reference Norms Guide - Balance, oculomotor, and gait normative data with age-stratified values and fall risk indicators
• Maddox Rod Testing Guide - Bedside vertical deviation screening with step-by-step instructions and referral criteria
• Vestibular Diagnostics Reference Guide - Links bedside examination findings to laboratory diagnostics (vHIT, VNG, VEMP, rotary chair)
• Dizziness Differential Algorithm (DDA) v12 - Real-time clinical flowchart — from symptom presentation to working diagnosis
• Medications Quick Reference Guide - Consolidated two-section guide: Acute Vertigo & Nausea Management + Ototoxic Medication Screening
• Vestibular Illness Scripts (8 Disorders) - Pattern recognition frameworks: enabling conditions, pathophysiology, and clinical consequences for the 8 most common vestibular diagnoses
• Assessment Sentences Library - Pre-written, evidence-based clinical statements with medical necessity language — ready to adapt for any vestibular presentation
• List of Vestibular Diagnoses with ICD-10 Codes - Comprehensive, current coding reference organized for quick clinical lookup
• Therapy Goals Library (25 SMART Goals) - Evidence-based goals across 5 categories with MCIDs, fall risk indicators, and functional outcome language

5 continuing education hours - On-demand educational modules you can watch anytime to explain the clinical why behind every assessment component

Step-by-step demo videos - See exactly how to perform each assessment

Treatment progressions - Step-by-step treatment progressions to help decrease the cognitive load of developing rehab activities

Downloadable templates ready for your practice - A vestibular evaluation resource with 64 targeted questions. Template assessment sentences and goal writing. Treatment progressions based on findings in your assessment. Print them. Use them tomorrow.

And Lifetime Access!

What You'll Walk Away With:

✓ A step-by-step evaluation template you can use immediately in your practice

✓ Confidence in the order and execution of vestibular tests

✓ Documentation that balances conciseness and thoroughness

✓ A vocabulary guide: terms to use and terms to avoid

✓ A systematic approach that works in any clinical setting

Click here to learn more