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Otolaryngology Coding Alert

4 Tools Improve Your Scope Visit Pay
How to combat a key ENT problem You can get payers to cover diagnostic scopes, such as na... Read more
NCCI 9.3 Update:
You Can't Unbundle These Audiology Codes
Medicare adds function test edits It's official: You should no longer report 92552 or 925... Read more
Think You've Made Your Case For Modifier -22?
5 steps get your unusual procedure claims paid If you're submitting claims when your otol... Read more
Reader Question:
Use 99024 for Global Period-Related Visits
Question: Two weeks after surgery, a patient presents for a tonsillectomy follow-up visit.... Read more
Reader Question:
Diagnostic Supervision Rules Exempt Audiologists
 Question: An audiologist performed scheduled electronystagmographies (ENGs) (92541-9... Read more
Reader Question:
Count Self-Referrals as Office Visits
Question: A patient who has frequent sinus headaches self-referred herself to my otolaryng... Read more
Reader Question:
Tympanostomy Is Myringotomy With Tubes
Question: An otolaryngologist performed a myringotomy with tubes under general anesthesia.... Read more
Reader Question:
Patient's Status Drives Component E/M Coding
Question: During an office visit, my otolaryngologist performed an expanded problem-focuse... Read more
Reader Question:
Bill 92547 per Placement
Question: When my audiologist uses our new video electronystagmography machine, I bill fou... Read more
You Be the Coder:
Excision Requires Full-Thickness Graft
Question: The otolaryngologist excises a basal cell carcinoma tumor from a patient's nasal... Read more
3 Tips Improve Your Audiology Reimbursement
Get paid for component servicesIf you're not taking advantage of modifiers -TC and -26 for... Read more
We'll Show You When to Code Function Test Components
Clip-and-save audiology reimbursement guide You can get paid for audiology services even... Read more
Is Your Consult Coding Opening the Door to Paybacks?
Experts reveal 99241-99255's who, what and where requirements You can get the added reven... Read more
Safeguard Your 99241-99255 Pay With a Self-Audit
3 steps support consultation coding If the government finds that your consultation docume... Read more
Protect Your ENT From OIG 2004
Medicare is focusing on these 5 areas You should pull sample charts to make sure your oto... Read more
Reader Question:
3 Factors Affect Cyst Removal Coding
Question: Which CPT code should I use for pre-auricular sinus excision?Nebraska Subscriber... Read more
Reader Question:
Assign 95165 for Entire Vial
Question: Should I report 95165 to Medicare when the nurse gives each injection or when sh... Read more
Reader Question:
Report Incorrect Readings
Question: Should we code a hearing test when the test is inaccurate? When an audiologist p... Read more
Reader Question:
Sort Out Office Scope With 69210
Question: When my otolaryngologist performs ear debridements in the office to remove wax, ... Read more
Reader Question:
Don't Separately Report Recovery Days
Question: My otolaryngologist frequently keeps thyroidectomy patients in the hospital for ... Read more
Reader Question:
A Simple Tool Combats Downcoding
Question: An insurer downcodes E/M visits because the diagnoses don't support the service ... Read more
Reader Question:
Turbinate Reduction Requires Modifier -52
Question: My otolaryngologist dictated the following operative report: "I reduced the righ... Read more
You Be the Coder:
Know Current 30465 Edits
Question: I thought that the National Correct Coding Initiative (NCCI) reversed its bundle... Read more
3 Examples Help You Achieve Flawless 92551 Reporting
Recoup same-day services with modifier -25Are your forfeiting payment for office visits wi... Read more
Are Payers Denying 9921x-25 With 92551?
2 field-tested tips for breaking E/M bundlesIf you use modifier -25 correctly on office vi... Read more
Coding Case Study:
Recoup $100 With Layered Closure
Excision includes simple closure only If you don't read down to the last line of ... Read more
3 Proven Strategies for Boosting Your Diagnosis Pay
Get inside your ENT's head to code E/M services appropriatelyWant an easy way to bump that... Read more
Reader Question:
Bill an E/M With Nosebleed Control
Question: A new patient presents complaining of chronic nosebleeds. During the exam, her n... Read more
Reader Question:
Consider 2 Options for Reporting Maneuvers
Question: How should I report an Epley maneuver and a Hall Pike test? Will insurers cover ... Read more
Reader Question:
69801-52 Includes Multiple Treatments
Question: When a patient requires a second Decadron injection during a labyrinthotomy 90-d... Read more
Reader Question:
Single-Anatomy Exam Qualifies for 92502
Question: Using general anesthesia, our ENT physician examines only a young patient's nose... Read more
Reader Question:
9271 Requires 3 Components
Question: A family physician (FP) asks our otolaryngologist to give his opinion on a compu... Read more
Reader Question:
Sort Out Component and Complete Services
Question: We bill all allergy injections and antigen preparation Medicare's way (component... Read more
Reader Question:
Medialization Laryngoplasty Code Proves Elusive
Question: After undergoing surgery for a knife wound to the neck, a patient requires media... Read more
Reader Question:
Insurers Implement 69424 Edits
Question: My otolaryngologist removes an aural polyp and a pressure-equalizing tube. The p... Read more
You Be the Coder:
Reserve Modifier -59 for Bundled Procedures
Question: My otolaryngologist performs a tonsillectomy and typanostomy on the same day in ... Read more
Get Reimbursement for UPPP With These 3 Simple Steps
Experts reveal how you can stop those 42145 denials Trying to receive payment for uvulo... Read more
3 Cerumen Removal Tips... that can save your practice $45 per episode
Reporting 69210 when your otolaryngologist doesn't use instrumentation to remove cerumen c... Read more
Short List of Top ENT ICD-9 Changes:
New Code for Barrett's Esophagus You Don't Want to Miss
If you don't like using an unspecified code for Barrett's esophagus, ICD-9 2004 will allev... Read more
Can't Figure Out Post-Op Procedure Denials?
We'll tell you which modifier will make insurers pay up Although you may blame payers f... Read more
Reader Question:
Watch Out: 30802 Is a 'Separate Procedure'
Question: Our office gets denials from insurance companies stating that turbinate cauter... Read more
Reader Question:
Choose Office Visit or Consultation Based on Intent
Question: A patient presents to my otolaryngologist for a right neck mass after an emerg... Read more
Reader Question:
Number of Sticks Determines 95024 Versus 95027
Question: Should I use 95024 or 95027 for allergy skin tests? Also, should I code based ... Read more
Reader Question:
Get Paid for Normal Hearing Diagnosis
Question: A mother presents with her 3-year-old son. She is worried that the child can't... Read more
You Be the Coder:
No Sinus-Surgery Global Period? Think Again
Question: After an otolaryngologist performs an ethmoidectomy on a non-Medicare female, sh... Read more
Which New ENT Combos Will Trigger a Rejection? NCCI Cracks Down on Billing Multiple Scopes
Don't bill for looking at the larynx or pharynx before performing 43200-43232. The lat... Read more
NCCI 9.2 Limits FEES/FEEST Code Combos
Otolaryngologists who perform swallowing studies to diagnose dysphagia or employ spe... Read more
What No Ones Telling You About 69990 With Ear Surgery
Failing to bill commercial payers for 69990 when performed in addition to middle and inn... Read more
Reader Question:
42300-42305 Contain More Than You Think
Question: Which codes should I use for incision and drainage (I&D) of a parotid absc... Read more
Reader Question:
Sniff Out Sensitivity Test Limitations
Question: When my otolaryngologist performs allergy testing (86003, 95004, 95024, 9502... Read more
Reader Question:
Sort Out Which Procedures 69631 Includes
Question: My doctor performed a left tympanoplasty with a stapes mobilization. He did not ... Read more
Reader Question:
Tune Into Ancillary Staff Rules for 92552-92557
Question: Our practice has a new medical assistant (MA) who performs audiograms. How sho... Read more
Reader Question:
Family Counts for E/M Service
Question: The otolaryngologist diagnoses a 10-year-old patient with sinus disease and re... Read more
Reader Question:
Timing, Documentation Pin Down Trach Changes
Question: When my otolaryngologist changes and/or removes a trach, how should I report t... Read more
You Be the Coder:
Check Location Before Using 70210
Question: My otolaryngologist orders x-rays for two sinus views and interprets them. How s... Read more
Does Your ENT Want Mohs Reimbursement? First Find Out if Hes Doing Mohs
Your otolaryngologist may push you to bill 17304-17310 for the extensive wor... Read more
Two Roles, One Doc:
Assign 17304-17310
Now that you know that your otolaryngologist meets CPT's criteria for Mohs surgery, make s... Read more
Dont Shy Away From ED Codes:
When ENT Assumes Care, They Are the Right Choice
If you believe that Medicare allows billing only one ED visit per day, you may b... Read more
Are You Using 99241-99245 for ED Visits?:
Heres When Its OK to Do So
If you routinely bill visits to the ED as consultations, think again unless the vis... Read more
Eliminate ED Coding Crises With This Clip-and-Save Chart
          The chart above offers examples of what oc... Read more
Correction:
Maxillectomy Determines Coding
In the April 2003 Otolaryngology Coding Alert, the answer for Unmask Ins and Exs of Sinus ... Read more
Reader Questions:
Stop Snoring With Payment
Question: My otolaryngologists are starting to offer injection snoreplasty. How should I... Read more
Reader Questions:
Surgeons Role Determines 95920 Coverage
Question: My otolaryngologist performs 69641 (Tympanoplasty with mastoidectomy [includ... Read more
Reader Questions:
Staple Down a Pouch Removal Code
Question: How should we bill for an "endoscopic" removal of Zenker's diverticula?Colorad... Read more
Reader Questions:
Break Down Medicares Injection, Provision Coding
Question: The June 2003 Otolaryngology Coding Alert reader question "Follow Daily Shot P... Read more
Reader Questions:
Define Open and Closed Treatment and Diagnosis
Question: Is an open or closed fracture the same thing as open and closed treatment?... Read more
You Be the Coder:
The Repair Makes All the Difference
Question: Our otolaryngologist re-excises a 3.5-cm neck scar that requires layered closure... Read more
Are You Fed Up With Inferior Turb/FESS Denials?:
Employ 5 Successful Strategies to Get Paid for Turbinate Removal and Ethmoidectomy
If you want to stop denials for 30130-30140 performed with 31254-31255, you're goi... Read more
Justify Medical Necessity to Win 30130-30140,31254-31255 Payment
To avoid payers 'thinking that your otolaryngologist performed an inferior turbinect... Read more
Modifier Management:
What to Do When Your ENT Provides Postoperative Care
Correctly indicating to a payer how a service or procedure is related or not to anothe... Read more
Clarification:
Endoscopy Coding Requires Designated Approach
Although the April Otolaryngology Coding Alert article "Stop Draining Sinus Surgery Re... Read more
Reader Question:
Compare Collection Terminology
Question: How should I report nasal endoscopy "with cultures"? Is this the same as... Read more
Reader Question:
Scope Service-Modifiers Roles
Question: When we perform an office visit or a consultation that results in 92... Read more
Reader Question:
Pick Out Trachea Procedures
Question: How should I code rigid tracheoscopy with tracheal dilation through establis... Read more
Reader Question:
Cyst Removal Sparks Denials
Question: When we perform sinus surgery, specifically procedures 30520, 31255-31256, 3... Read more
Reader Question:
Follow Daily Shot Protocol
Question: When administering allergy shots to a patient whose otolaryngologist is off-... Read more
You Be the Coder:
Square Away Reconstructive Procedures
Test your coding knowledge. Determine how you would code this situation before looking a... Read more
Dont Get Sore Over Tonsillectomy And Adenoidectomy Coding Pitfalls
ENT coders who report tonsillectomies as one of their practice's mainstays must prop... Read more
Otorhinolaryngologic Services Are Under Fire by NCCI
The latest version of the National Correct Coding Initiative (NCCI) targets 92502-9270... Read more
Coupon Leaves No Excuses for Edit Ignorance
Otolaryngologists and coders who complain of difficulty keeping up with the cons... Read more
Take a Close Look At Your Practices Microscopy Coding
Some otolaryngologists push for billing microscopy, leaving coders to battle the appro... Read more
Reader Question:
Clear the Way to Visit,Audio Reimbursement
Question: When my otolaryngologist sees a patient and the audiologist performs a subse... Read more
Reader Question:
Measure Your Re-Excision Knowledge
Question: How should I pick the size of the malignant lesion code when my otolaryngolo... Read more
Reader Question:
Opinions Count With Intraoffice Consults
Question: A pediatrician requests that two specialists from my practice, a pediatric E... Read more
Reader Question:
Two Codes Cover Graft Alternative
Question: How should I bill for Cymetra? Maryland Subscriber Answer: Cymetra is a mi... Read more
You Be the Coder:
Further Hemorrhaging Leads to More Work
Test your coding knowledge. Determine how you would code this situation before looking... Read more
Stop Draining Sinus Surgery Reimbursement With 7 Tips
With sinus endoscopy surgeries ranking among some of the most common procedures ot... Read more
Flush Out Diagnostic Fraud
Seeing the potential areas for reimbursement loss from FESS may start you searching fo... Read more
Form Letter Eliminates Post-FESS Headaches
Fight private payers that contradict Medicare rules and deny follow-up service... Read more
Dont Let IDT Misconceptions Stick Around
Despite CPT's revision of 95027, intradermal dilutional testing (IDT), commonly call... Read more
Reader Question:
Cut Out Graft Confusion
Question: When the doctor performs 69631, should I bill for a temporalis fascia graft?... Read more
Reader Question:
Listen to Audiograms Reason
Question: A Medicare beneficiary presents complaining only of hearing loss. After the ... Read more
Reader Question:
Start Recouping Tube Checks
Question: For 69436, can we charge for the first postoperative visit after the 10-day ... Read more
Reader Question:
Unmask Ins and Exs of Sinus Access
Question: Does a code exist that describes a midface degloving approach? The otolaryng... Read more
Reader Question:
Eliminate the Normal Suspects
Question: How should I report a nasal culture when the otolaryn-gologist suspects that... Read more
You Be the Coder:
Wake Up to Hyoid Reimbursement
Test your coding knowledge. Determine how you would code this situation before looking... Read more
CMS Packs Fee Schedule With Directives on Cerumen Removal, FEES/FEEST, Speech Codes
Although otolaryngologists welcome the new cerumen removal code (G0268), Medic... Read more
NCCI Delights ENTS With RND, Shocks With Excision Inclusion
Otolaryngologists can now bill for bilateral radical neck dissections (RND) in add... Read more
Fee Schedule Update:
Lawmakers Reject Conversion Factor Cut, Increase Rates
The U.S. House and Senate voted to eliminate the scheduled 4.4 percent conversion factor... Read more
Reader Question:
Clear the Way to Eustachian Tube Tests
Question: Which CPT code should I use for a eustachian tube dysfunction test? Wis... Read more
Reader Question:
31601 Involves More Work, Less Pay
Question: The January Otolaryngology Coding Alert states that 31601 has more rel... Read more
You Be the Coder:
To Append an Attempt or Not
Test your coding knowledge. Determine how you would code this situation before looki... Read more
Resolve Post-Tracheostomy Billing Issues with Three Questions
When reporting post-tracheostomy care, be sure to consider coding for follow... Read more
ENT Receives a Double Whammy:
Fee Schedule for 2003 Slashes RVU Reimbursement,Amount
Medicare not only cut relative value unit (RVU) reimbursement for 2003 in the Phys... Read more
Dont Let the Interim Fee Schedule Rules Drive You Crazy
Juggling two fee schedules for one calendar year could drive the most patient otolaryn... Read more
The 2003 Fee Schedules Bottom Line:
CMS Cuts E/M Reimbursement Levels
   ... Read more
Reader Question:
On-Call Requires Patient-Specific Attendance
Question: How do the new on-call codes apply? Insurers will likely not pay for the t... Read more
Reader Question:
Roll Ear-Wick Placement into E/M Service
Question: Does a code exist to describe placement of an ear wick? Virginia Subscriber... Read more
Reader Question:
Consult Depends on Service,Not Diagnosis
Question: A family practitioner referred a patient with a diagnosis code to our otol... Read more
Reader Question:
Include In-Office Tube Removal in E/M
Question: If we remove tubes inserted by another physician in the office, how should... Read more
You Be the Coder:
CCI Changes Billing for Bilateral,Modified RND
Test your coding knowledge. Determine how you would code this situation before looking a... Read more
Answer Five Questions to Determine the Appropriate Trach Code
Reviewed on May 21, 2015 "To alleviate confusion concerning coding for tracheos... Read more
Four Tips Sort Out E/M With Minor Procedure
Coding an E/M service with a minor procedure never ceases to stump even the most... Read more
Five Guidelines Clear the Way to Asthma Coding
By following five tips to report the appropriate fourth- and fifth-digit asthma code... Read more
Answer Three Questions to Resolve 99211 Payment Issues
By reviewing who performed the service, the service performed and the associated d... Read more
Reader Question:
Bill Injections Based on Supervising Physician
Question: When administering shots to a patient whose physician is on vacation, sh... Read more
Reader Question:
Use Determines Poisoning/Reaction Diagnosis
Question: An allergy patient on prednisone presented with nervousness, a headache ... Read more
Reader Question:
CCI Bundles Nebulizer Treatment,Training
Question: Does 94060 include the breathing treatment, or should I report a separ... Read more
Reader Question:
How to Code for Injection With Supplied Serum
Question: We have a patient who receives allergy injections at our otolaryngology of... Read more
Reader Question:
NPP Rules Affect E/Ms in the Hospital,Not Office
Question: I've heard that CMS issued a memorandum regarding new nonphysician pract... Read more
Reader Question:
Know Serum Preparation,Administration Rules
Question: How should I charge 95165 for an immunotherapy allergen kit? We make a kit... Read more
Reader Question:
Use Allergy for Primary Diagnosis
Question: How should I code the diagnosis for allergy shots? Should I report V07.1... Read more
Reader Question:
Injections Include Needles
Question: Should I bill for the needles used during allergy injections? Michigan Subs... Read more
Reader Question:
Bill Vestibular Test Per Irrigation
Question: When my audiologists perform two warm and two cold calorics, they bill four ... Read more
Reader Question:
Modifier -50 Is Payer-Specific
Question: On a bilateral procedure, should we bill the procedure twice with one proc... Read more
Reader Question:
Provider, Payer Determine Nerve Monitoring
Question: When an otolaryngologist performs facial nerve monitoring in an outpatient s... Read more
You Be the Coder:
Use Keywords to Select Laryngoscopy Code
Test your coding knowledge. Determine how you would code this situation before lo... Read more
Available Years:  2003  2002  2001  2000  1999