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Otolaryngology Coding Alert

CPT 2001 Promises Greater Reimbursement With the Addition of New Otolaryngology Codes
CPT 2001 includes several important changes for otolaryngologists, including new codes for... Read more
New G Codes Ease Coding of Swallowing Evaluations
The Health Care Financing Administration (HCFA) has proposed two new codes that would be u... Read more
New Modifier Recognizes Additional Work for Revisions
CPT 2001s new modifier -60 (altered surgical field) could be good news for otolaryngologis... Read more
Reader Question:
Bilateral Turbinate Resection
Question: Claims for bilateral turbinate resections performed in our office have been deni... Read more
Reader Question:
Not All Edits Are Found in CCI
Question: A physician in my office always wants to bill 69440 (middle ear exploration thro... Read more
You Be the Coder:
Septoplasty or Rhinoplasty
Question: My otolaryngologist and I disagree on how to code the following session: A hemi-... Read more
Correct Use of Modifier -59 for Bilateral Neck Dissections Optimizes Payment
"Neck dissections are difficult to code because they often are associated with a pr... Read more
Case Study:
Payment for Atypical Procedures Demands Operative Note Clarity
"The notion that procedures should never be billed solely on the listed procedures ... Read more
Reader Question:
Acoustic Reflex Testing Codes
Question: Our carrier has begun to deny 92568 as inclusive in 92569 although CPT shows it ... Read more
Reader Question:
Exam Under Anesthesia
Question: How should I code for an exam of the ears under anesthesia, removal of tympanost... Read more
Reader Question:
Dont Substitute 92511 for 31231
Question: In central New York, a major carrier has implemented a 20 percent coinsurance on... Read more
Reader Question:
Inappropriate Edits
Question: Local carriers in our area have been bundling procedure codes 99213-25 and 31231... Read more
You Be the Coder:
Tube Check
Question: What diagnosis code should be used when a patient returns six months to one year... Read more
Recognize Key Words to Bill Effectively for Laryngoscopy Procedures
Using the wrong laryngoscopy code can be a costly error. A relatively simple procedure suc... Read more
Case Study:
Get Paid for Cholesteatoma Removal Based on the Procedure
The removal of most cholesteatomas of the tympanic membrane and middle ear during tympan... Read more
Reader Question:
Revision of Sinus Endoscopy
Question: How do you code the revision of an ethmoidectomy or sphenoidotomy?Texas Subscrib... Read more
Reader Question:
Unbundled Services
Question: We are using codes 99211, 95125 and 95165. We use 95165 only when vials are made... Read more
You Be the Coder:
Nasogastric Tube Insertion
Question: How do I code for an esophagoscopy with nasogastric tube insertion?Oregon Subscr... Read more
How to Appeal Denials When a Medicare Carrier Bundles Inferior Turbinates With Ethmoidectomy
Some local Medicare carriers are bundling inferior turbinectomies with ethmoidectomies, an... Read more
Careful Coding of Panendoscopy May Override Edit to Get Payment
In some cancer or trauma patients, otolaryngologists may perform three endoscopic proced... Read more
Grafts Are Separately Payable On Septal Perforation Repair
Repairing a perforated septum is a complex and time-consuming procedure. The CPT code used... Read more
Reader Question:
V Code Diagnosis
Question: We are not getting paid for V codes when they are used for ear and hearing exams... Read more
Reader Question:
Acoustic Reflex Testing
Question: Our local Medicare carrier is denying CPT 92568 as inclusive in 92569, although ... Read more
You Be the Coder:
Vocal Cord Injection
Test your coding knowledge. Determine how you would code this situation before looking at... Read more
Method of Repair Determines Payment for Scar Revision
There are many different ways that scar revisions can be coded, and distinguishing among t... Read more
CCI Revisions Limit InstaTrak Billing
The latest version of the national Correct Coding Initiative (CCI), version 6.2 of the Hea... Read more
General Anesthetic Exams Get Bundled
Another Correct Coding Initiative (CCI) 6.2 change has otolaryngological examinations perf... Read more
Detailing Patient History Means Higher Reimbursement
Taking a patients history is probably the easiest component of an evaluation and manageme... Read more
Reader Question:
Determining the Need for Debridement
Question: If I see a postoperative endoscopic sinus surgery patient and do a debridement a... Read more
Reader Question:
Nasal Fracture Stabilization
Question: Regarding CPT codes 21315 (closed treatment of nasal bone fracture without stabi... Read more
Reader Question:
Unlisted Code for Swim Plugs
Question: We have recently been advised Tricare/Champus will pay for custom-made swim plu... Read more
You Be the Coder:
Partial vs. Total Ethmoidectomy
Test your coding knowledge. Determine how you would code this situation before looking at... Read more
Gain Reimbursement by Correctly Coding PE Tubes Removal
Some otolaryngologists have reported using 69200 (removal of foreign body from external au... Read more
Non-physician Provider Services Can be Tricky but Rewarding
Otolaryngologists can free up a lot of their time to perform well-paid procedures if they ... Read more
Physician/Coder Communication Critical for ED Services
Otolaryngologists typically get called to the emergency department (ED) for cases of sever... Read more
Reader Question:
Arch Bar Removal
Question: Does the code 21462 (open treatment of mandibular fracture; with interdental fix... Read more
You Be the Coder:
Epistaxis Control With Endoscopy
Test your coding knowledge. Determine how you would code this situation before looking at... Read more
Combat Denials of Postoperative Care After Sinus Endoscopy
It pays for otolaryngologists to have a strategy in place when commercial carriers reject ... Read more
Signs and Symptoms Increase Pay Up and Safeguard Patients
ICD-9 signs and symptoms codes should be used to provide medical necessity for a procedure... Read more
Samples of Billing Signs and Symptoms
As discussed in the previous article, otolaryngologists encounter a variety of diagnosis c... Read more
Reader Question:
Contracting Hospital Equipment
Question: I am an ENT located next door to the hospital. Frequently primary-care physician... Read more
Reader Question:
Acoustic Reflex Testing Codes
Question: United Healthcare has begun to deny CPT 92568 as inclusive in 92569, even though... Read more
Reader Question:
Coding Laser Removal of Palate Tumor
Question: What is the proper code for the removal of a palate tumor with a laser?Charles B... Read more
Reader Question:
Removal of Facial Lymph Node
Question: How do I code for the removal of a lymph node from the jaw and face area?Califo... Read more
You Be the Coder:
Coding Sinus X-rays
Test your coding knowledge. Determine how you would code this situation before looking at... Read more
Documentation Critical When Billing For Late Repair of Nasal Fractures
There is no specific CPT code for late repair of nasal fracture. As a result, otolaryngolo... Read more
Proper Documentation:
Get Paid for Same-day Septoplasty and Turbinate Resection
Otolaryngologists in growing numbers are reporting that when they bill for a septoplasty (... Read more
Look for Corrections to CCI Version 6.1 Errors
Due to a large number of errors, the implementation of the national Correct Coding Initiat... Read more
Reader Question:
Arteriovenous Malformation
Question: I recently performed surgery on a patient with an arteriovenous malformation (AV... Read more
Reader Question:
Percutaneous Botox Injections
Question: Botox injections are being billed as 31513 for procedure and J0585 for the Botox... Read more
You Be the Coder:
Coding Office Visits After ER Visits
Test your coding knowledge. Determine how you would code this situation before looking at... Read more
Successfully Appeal Inappropriate Septoplasty Denials to Gain Reimbursement
Many insurance carriers still inappropriately bundle endoscopic sinus procedures with sept... Read more
New Codes Expand Billing for Laceration Repair
Until Jan. 1, 2000, otolaryngologists and other surgeons had to use one code (11330, now d... Read more
Minimal E/M Exam Must Be Documented to Bill 99211
Even though 99211, the level one code for an established patient, does not require documen... Read more
Reader Question:
Canalith Repositioning Procedure
Question: I am looking for a CPT code to describe a procedure we do in our office called t... Read more
Reader Question:
Billing New Patient Visit
uestion: A new physician joined our practice. He is seeing a patient that he has never see... Read more
Reader Question:
Biling for New Equipment
Question: Our local hospital recently has purchased new equipment called Insta-Trak that m... Read more
You Be the Coder:
Lymph Node Removal
Test your coding knowledge. Determine how you would code this situation before looking at... Read more
Fees:
Optimize Reimbursement for Swallowing Test
When billing for their otolaryngologists involvement in fiberoptic, or functional, endos... Read more
Prudent Use of Prolonged Services Can Be Profitable
Prolonged services are a good way for otolaryngologists to get reimbursed for significant ... Read more
'Findings' Section in Your Op Report Can Make Biling Easier
Otolaryngologists should include a short section in their op notes that explains what they... Read more
Reader Question:
Tube Removal, Membrane Repair
Question: PE tubes were put in a patients ear by another physician who is not in our group... Read more
Reader Question:
Prolonged Services
Question: I saw a patient for a Ludwigs angina without abscess formation (528.3). Due to h... Read more
You Be the Coder:
Vestibular Function Test
Test your coding knowledge. Determine how you would code this situation before looking at... Read more
Ensure Proper Reimbursement for UPPPs
Otolaryngologists often treat obstructive sleep apnea by performing a uvulopalatopharyngop... Read more
Get Paid for Epistaxis Control With Endoscope
Otolaryngologists often use a scope when controlling epistaxis (nosebleeds). And CPT pro... Read more
Case Study:
Avoid Losing Pay Up by Targeting Op Report Oversights
Otolaryngologists need to be specific and accurate when dictating their operative notes. T... Read more
Services for Patients With Obstructive Sleep Apnea
Most private insurance companies require a sleep study (polysomnography) to prove that the... Read more
Correction
The November 1999 issue of Otolaryngology Coding Alert incorrectly stated that Medicare ha... Read more
Reader Question:
Modifier 51 vs. Modifier 59
Question: In the August 1999 Otolaryngology Coding Alert on page 12, you use the example o... Read more
Reader Question:
Modifier 57 and Billin E/M
Question: When I see a new patient for chronic cough, perform an evaluation and management... Read more
Reader Question:
Code 31231 Bundled Into Comprehensive Laryngoscopy
Question: In the July 1999 Otolaryngology Coding Alert on page 7, there was a question con... Read more
Reader Question:
Final Flap Repair Release
Question: My otolaryngologist is going to excise a basal cell carcinoma from a patients ea... Read more
You Be the Coder:
Many Diagnosis Coded Justify Esophagoscopy
Test your coding knowledge. Determine how you would code this situation before looking at... Read more
Documenting Signs or Symptoms, Patient History Key to Payment for Late Repair of Nasal Fracture
When a patient who years earlier had a nasal fracture requires treatment to repair damage ... Read more
Correctly Documenting Endoscopic Tissue Removal can Increase Pay Up
Otolaryngologists often run into problems when billing for tissue removal performed during... Read more
Case Study:
Increase Reimbursement For Team Skull Surgery
When two surgeons work together to perform a complicated procedure, they bill the procedur... Read more
Brief:
Coding Right Thyroid Lobectomy
Tipper Gore, wife of Vice President Al Gore, recently underwent surgery to remove a nodule... Read more
Reader Question:
Surgical Laryngoscopy With Diagnostic Bronchoscopy
Question: When the doctor performs a direct laryngoscopy with biopsy (31535) he may procee... Read more
Reader Question:
Preauricular Cyst Excision
Question: How would you code an excision of an infected preauricular cyst or sinus? Code... Read more
You Be the Coder:
Billing Allergy Injections
Test your coding knowledge. Determine how you would code this situation before looking at... Read more
Available Years:  2000  1999