Advanced Search

Otolaryngology Coding Alert

Confused About Trach Tube Changes? Here's the Essential Knowledge You Need
Reviewed on May 15, 2015 Post-fistula procedures may call for unlisted-procedure cod... Read more
Breaking News:
CPT 2006 Revises Turbinate Surgery Codes
Unlisted-procedure code becomes the choice for middle turbinate fractureFor 2006, CPT will... Read more
Don't Fret Over Tube Change Options:
Check This Chart for the Answer
Want an easy way to choose the correct tracheostomy tube change code? Using the grid above... Read more
3 Tips Mean 'Unlisted' Doesn't Have to Mean Unpaid
Payment for unlisted-procedure codes requires preparation and documentationIf you-ve ever ... Read more
Keep Watching Otolaryngology Coding Alert!
Look to the January and February 2006 editions of Otolaryngology Coding Alert for a comple... Read more
READER QUESTIONS:
Specificity Matters for Asthma Dx
Question: Do we need a fifth digit when reporting an asthma diagnosis, such as 493.2?North... Read more
READER QUESTIONS:
Watch for Spirometry/Nebulizer Treatment Bundles
Question: May I report a separate procedure (94640) for breathing treatment with bronchosp... Read more
READER QUESTIONS:
Report 69990 With Caution
Question: What are the requirements for reporting the operating microscope (69990)? It see... Read more
READER QUESTIONS:
Programming Is Separate With Cochlear Implant
Question: Is analysis/programming of a cochlear implant included in 69930, or can we repor... Read more
READER QUESTIONS:
Charge Outpatient Consult for Observation
Question: Another doctor asked my ENT for a consult with a patient who had been admitted f... Read more
You Be the Coder:
'Close Enough' Isn't for Endoscope
Question: The doctor used an endoscope to remove a posterior nasal lesion. May I report 30... Read more
Ace Your Tracheostomy Claims in 4 Steps
Beware separate-procedure status of planned tracheostomyPayment for the physician portion ... Read more
Pick the Correct E/M Modifier Every Time:
Here's How
Assign 57, not 25, for E/M prior to major surgical procedureYour surgeon performs an E/M s... Read more
Clip and Save:
Tonsillectomy/Adenoidectomy Coding Made Easy: Add It Up
Here's a quick way to select the correct tonsillectomy and/or adenoidectomy code: Just che... Read more
Call on 24 for Complication Evaluations-Maybe
Medicare will only allow return to OR with 78CPT rules allow you to report an E/M service ... Read more
Here's Your Solution for Noncovered Procedures
Tell patients up front about possible financial responsibilityIf you don't want to get cau... Read more
READER QUESTIONS:
Look for a '1' Indicator to Unbundle NCCI
Question: When can I unbundle NCCI edits?Georgia Subscriber Answer: Each National Correct... Read more
READER QUESTIONS:
Bill Botox Injections in Several Steps
Question: How should I bill for EMG guidance with percutaneous vocal-cord injection using ... Read more
You Be the Coder:
Can You Report Suture Removal?
Question: Recently, we experienced circumstances that required the ENT to remove sutures i... Read more
CPT Rings in the New Year With Streamlined Consultation Coding
Start bulletproofing your modifier 25 service documentation Throw away your notes on dis... Read more
Count 2 Vignettes as Follow-up Inpatient Consults
Treatment delay or change makes 99261-99263 appropriate--at least for now You won't have ... Read more
Seasoned Editor Takes Helm of Otolaryngology Coding Alert
The November Otolaryngology Coding Alert will introduce readers to a different writing sty... Read more
Follow 2 Important Lessons to Code Nebulizer Education Accurately
Get the pay you deserve for inhaler demonstrationsDon't let your allergist's or nurse's ti... Read more
4 Ways to Improve Your G0375-G0376 Reimbursement
Good news: CMS gives you more options for coding this service If your allergist counsels ... Read more
New V Codes Strengthen Your Vaccination Coding
A missing fifth digit could stand in the way of your reimbursementIf you-ve had trouble re... Read more
How to Ethically Report Nurse Visits With Immunizations
And be sure you avoid this one common pitfall at all costsAlthough you might be tempted to... Read more
Reader Questions:
3 Tips Help Obtain Payment for DL With Bronch
Question: Medicaid bundles 31525 and 31622 when we bill them together. What can we do to a... Read more
Reader Questions:
Reserve 55 for Post-Op Package
Question: Would you please explain when we should use modifier 55? I am not clear on what ... Read more
Reader Questions:
Unrelated, Turb-Post-Op OV Requires Modifiers
Question: A patient who is returning for follow-up after unilateral endoscopic maxillary a... Read more
READER QUESTIONS:
Avoid Undefined Asthma and Assign the 5th Digit
Question: An elderly patient came to our practice with a history of asthma-induced bronchi... Read more
READER QUESTIONS:
In the Absence of Details, Stick With What's on Paper
Question: The E/M guideline chart that we use to select the history level includes identif... Read more
READER QUESTIONS:
All Staff Can Perform History Element
Question: My coworker thinks an allergist must take a patient's history, but I think a nur... Read more
READER QUESTIONS:
Ask Payers Before You Report 99071
Question: Is there a way we can offset the cost of educational materials, pamphlets, etc.,... Read more
You Be the Coder:
Is 69205-50 Appropriate?
Question: An otolaryngologist removes a foreign body from both ears under anesthesia. Shou... Read more
You Be the Coder:
Append 76 for Multiple Nebulizer Treatments
Question: A patient with acute asthma requires three same-visit nebulizer treatments to co... Read more
Here's How to Fight for Turbinectomy Payment With Ethmoidectomy
Use rock-solid documentation, duel diagnoses and modifier 59 - and appeal those denialsEmp... Read more
NCCI 11.2 Targets Laryngoscopy Lesion Reconstruction Codes
Avoid unbundling errors with scope guidelines' reviewYou can tackle CMS' latest round of c... Read more
Some Bronchoscopy Codes Now Include 9 Lesser ENT Scopes
Count nasal/larynx scope as part of bronchoscopy, NCCI states You'll submit flawless bronc... Read more
How Astute Are You?:
CPT Manuals Eliminate Modifier Hyphen
Maintain your written correspondence's look, experts sayIf you noticed that this Otolaryng... Read more
READER QUESTIONS:
Look to 10021-10022 for Fluid Sampling
Question: An otolaryngologist performs fine needle aspiration (FNA) of a peritonsillar abs... Read more
READER QUESTIONS:
Encourages Tongue Reduction Code With 0088T
Question: I am considering using 0088T for a radiofrequency treatment on the base of the t... Read more
READER QUESTIONS:
Include Mirror Exam in E/M Code
Question: When an otolaryngologist performs a same-day office visit and mirror exam, shoul... Read more
READER QUESTIONS:
Code OV for Debridement Patient's New Problem
Question: A patient who is returning for follow-up after unilateral endoscopic total ethmo... Read more
You Be the Coder:
Check 2 Things When Coding Tube Removal
Question: An otolaryngologist makes an incision to retract a ventilating tube that was b... Read more
6 Guidelines Point You to the Correct Complicated Ear Diagnoses
" Report otomycosis' underlying disease, ICD-9 instructions indicate When c... Read more
Case Study:
Private Payers May Impose T&A/BMT Bundle
Override edit with modifier 59, when appropriate Your multiple-procedure modifier claims ... Read more
Consider These Options When ENT Visits Observation Patient
Capture overnight minor-procedure complication with 99217 You ethically deserve $70 in ob... Read more
Correction:
Steroid Injection Doesn't Require Modifier 52
Report transtympanic injection as 69801Modifier 52 is unnecessary on steroid injection cla... Read more
Reader Questions:
Fight Audio Service Inclusions With 3 Tips
Question: When a Medicare patient presents to our office with a chief complaint of "hearin... Read more
Reader Questions:
Code OP-Report-Backed FESS Guidance
Question: May I bill separately for stereotactic guidance (such as with the CT Sinus Insta... Read more
Reader Questions:
Maintain Incident-to Principles Using New Numbers
Question: Will the new National Provider Identifier (NPI) change how we report services in... Read more
Reader Questions:
Capture 31267 for Sinus Biopsy
Question: An otolaryngologist documented a procedure as:  left endoscopic maxillary ... Read more
You Be the Coder:
Decide Which Nasal Surgeries You Can Report
Question: An otolaryngologist performs a septoplasty, submucous resection of inferior turb... Read more
ICD-9's New Sleep Disturbance Codes Don't Put Duel Classification Issues to Rest
You'll have a detailed series to describe insomnia, apnea This fall's proposed... Read more
Here's How You'll Update Your Current OHS, Apnea, Hypersomnia Diagnoses
Laminate this cheat sheet for crosswalking 780.xx to the new 327.xx series Although getti... Read more
2-Physician Surgery Doesn't Make Modifier -62 a Shoe-In
Reserve co-surgery appendage for when ENT shares procedure You should limit modifier -62 ... Read more
2 Tips Help You Navigate TP Documentation Rules
Prove ENT's presence and involvement with rock-solid -GC entries You can ensure that your... Read more
Use This Scenario to Help You Report Critical Allergy Cases
The key to reimbursement is knowing how to report all the services If your allergist trea... Read more
6 New J Codes Make Inhalation Coding Easier
Bonus: Don't let premix and compound solution requirements mix you up You now have greate... Read more
Here's Advice You Need to Report Consultations With Accuracy
 Heads-up: You should be able to code 4 types of consults Knowing how to report a co... Read more
Reader Quextions:
Include Nasal Swab in Pre-Flu Test Work
Question: An allergist performs the QuickVue Influenza test in the office. Should she code... Read more
Reader Questions:
Use 1 Code for Endoscopic Nosebleed Control
Question: When an otolaryngologist provides epistaxis control using an endoscope, I report... Read more
Reader Questions:
Don't Lump Audio Services Into Global Period
Question: An otolaryngologist orders audiometry and tympanometry testing during a mastoide... Read more
Reader Questions:
Use AuD's PIN When ENT's Out
Question: I have a certified audiologist in my office who performs all hearing tests inclu... Read more
Reader Questions:
Include Endo-Antrostomy Attempt in Caldwell-Luc
Question: An otolaryngologist has to convert a Medicare patient's endoscopic maxillary ant... Read more
Reader Questions:
Keep an Eye on Electrode Placement EOBs
Question: You explain in June 2005's Otolaryngology Coding Alert article "Discover the Rea... Read more
Reader Questions:
Don't Inject 90782 Into TB Test Coding
Question: What is the correct injection code to file when a nurse injects PPD for a TB ski... Read more
Reader Questions:
Downcode to Documented Component Levels
Question: The chart that we use to select the level of history includes identifiers. For e... Read more
Reader Questions:
95117 Is Your Choice for Multiple Shots
Question: A nurse administers three immunotherapy injections to a patient. Should I report... Read more
Reader Questions:
Unspecified Asthma Codes Could Mean Denials
Question: An elderly patient with a history of asthma developed bronchitis. How should I c... Read more
Reader Questions:
The Right Times for You to Report 94060 and 94640
Question: My allergist performs pre- and post-treatment pulmonary function tests (PFTs). H... Read more
Reader Questions:
Think Twice When Reporting 93720 and PFTs
Question: Can I bill Medicare for code 93720 in addition to the other PFT codes?Oregon Sub... Read more
You Be the Coder:
Should You Bill Post I&D Packing Changes?
Question: An otolaryngologist performs the following inpatient procedures:  incision... Read more
You Be the Coder:
Asthma Education
Question: Our allergists offer a monthly asthma education service to current patients and ... Read more
Discover the Reasoning Behind ENG Tests Unit Rules
Codes 92543, 92547 permit multiple billings; 92542, 92545 don't You can avoid losing $40 ... Read more
Not Every ENG Test Code Permits Multiple Reporting
Clip and save your guide to 92541-92547 billing combos Even though no universal rule appl... Read more
You Can Get Paid for ENG-Test Portion and Postevaluation
Claim otolaryngologist's service with -26,  -TC and/or E/MIf you know when to us... Read more
This POS Test Will Combat Sleep Study, Observation Denials
Look at the result location, patient's status for box 24B entry Use this pop quiz to stop... Read more
2 Tools Solidify That the Doctor Asked for ENT's Opinion
CMS withdraws consult article, but experts still agree no letter necessary Even though a ... Read more
Reader Questions:
Avoid Saccade Bundles With 92545
Question: We bill a random saccade test for dizziness or vertigo with an unlisted-procedur... Read more
Reader Questions:
Column 'Z' Reveals Supervision Requirements
Question: An audiologist performs audiological tests off-site from the otolaryngologist. D... Read more
Reader Questions:
Medicare Doesn't Cover Routine Protime Tests
Question: A colleague thinks that our otolaryngologists shouldn't report PT and PTT tests ... Read more
Reader Questions:
Decide If 2 Pitfalls Make 'Unbundling' Worthwhile
Question: If a commercial carrier is paying separately for procedures the NCCI edits consi... Read more
You Be the Coder:
3 Factors Determine Frontal Sinusotomy Code
Question: An otolaryngologist makes a bicoronal incision down to the paracranium. He eleva... Read more
Simplify Tracheostomy Tube Replacement Coding With One of These Choices
"Strategy: Try 31899 for OR change under general anesthesiaEven though no code describes a... Read more
Skipping This Step Could Result in FESS, Audiogram Mispayment
Verify modifier -50 use with fee scheduleBefore you append modifier -50 to an ENT procedur... Read more
You're Responsible for Modifier -50 Reimbursement
Not doubling 31267 fee could cost you $175 plusYou can avoid shorting yourself maxillary a... Read more
READER QUESTIONS:
Pay Attention to Diverticulectomy Approach
Question: What CPT code should I report for an endoscopic cricopharyngeal myotomy using th... Read more
READER QUESTIONS:
Place Modifier -59 on Bundled Code
Question: How do I determine which code to append modifier -59 to?New Jersey Subscriber A... Read more
READER QUESTIONS:
Group Specialist Service Doesn't Establish Patient
Question: Is a patient a new or an established patient when a physician in one specialty t... Read more
READER QUESTIONS:
Code Definitive Dx, Not R/Os
Question: May I use 'rule out' (R/O) as the reporting diagnosis?Ohio Subscriber Answer: Y... Read more
READER QUESTIONS:
Office Codes Usually Pay More Than Facility
Question: What is the difference between facility and non-facility relative value units (R... Read more
You Be the Coder:
Consider Debridement's Relation to Flap Repair
Question: An otolaryngologist repairs a gunshot victim's facial and lip wounds. We are usi... Read more
2 Ways You May Report Laryngectomy With MRND
Find out why experts back billing both 31365 & 31360/38724-59 Weigh the reasons some ... Read more
Laryngectomy/MRND Claims Call For 1 of These Approaches
Consider volume, payer when determining 31365 or 31360/38724-59 strategy When deciding wh... Read more
Omitting Modifier -57 Jeopardizes Your E/M Pay
Tip: Decision-for-surgery service warrants reimbursement You could improve payment for... Read more
News You Can Use:
Mismatched Patient Info Triggers E/M, Scope Denials
Record the beneficiary's exact card data, or face nonpayment If Medicare denies 99213-25 ... Read more
HCPCS Update:
Are You Still Reporting 90782-90784 to Medicare? Think Again
Scoop: Medicare now pays for same-day injections and E/M services You can help your a... Read more
Let Expert Advice Guide Your 86580 Reporting
Why you may be incorrectly reporting 99211 for TB tests Your office can submit surefire t... Read more
What You Need to Master Nebulizer-Services Coding
Use our case studies to get paid for treatment and training every time If your allergist ... Read more
4 Easy Steps Help You Code Pneumonia Diagnoses
Hint: Double-check the documentation before you assign 480-486 You can code your allergis... Read more
Reader Questions:
Count Acoustic Rhinometry as Function Study
Question: Does 92512 appropriately describe "acoustic rhinometry," or should I report the ... Read more
Reader Questions:
Complex Surgery Requires Op Note Review
Question: My otolaryngologist performs resection of tonsillar fossa and right lateral phar... Read more
Reader Questions:
Tally Time Before Assigning Discharge Code
Question: During morning hospital rounds, an otolaryngologist discusses treatment plans wi... Read more
Reader Questions:
Check for Scope With Tonsil Biopsy
Question: How should I report a punch excisional biopsy of the left tonsil?Tennessee Subsc... Read more
Reader Questions:
Let NCCI Steer Your Modifier -59/-51 Use
Question: When should I use modifier -59 instead of modifier -51?California Subscriber An... Read more
Reader Questions:
Some Staff May Use New Vaccine Admin Codes
Question: When a nonphysician practitioner (NPP) who bills independently provides vaccine ... Read more
Reader Questions:
Count the Number of Immunotherapy Injections
Question: When should I report 95115 instead of 95117? What other codes are applicable?Ten... Read more
Reader Questions:
Include Pre Flu-Test Work in E/M
Question: When an allergist performs the QuickVue Influenza test in the office, may he als... Read more
Reader Questions:
Nebulizer, Vaccine Include Inherent Supply
Question: May we bill a syringe code with a vaccine administration code to non-Medicare/Me... Read more
Reader Questions:
Should You Factor Patient's Status?
Question: During an office visit, my doctor performed an expanded problem-focused history,... Read more
Reader Questions:
Tackle Synagis-Ig Rejections With 4 Actions
Question: How should I code a Synagis injection? Commercial insurers keep denying the proc... Read more
You Be the Coder:
How to Bill a Steroid Injection
Question: An otolaryngologist performs a transtympanic injection - he injects a steroid ... Read more
You Be the Coder:
Choose From 3 Options for Health Reviews
Question: Our office requires that new adult patients have a "new established visit." Duri... Read more
Medicare Now Permits Bilateral Mastoidectomy Billing
Receive 150 percent payment for patching both ears after tube removal When your otolar... Read more
You May Append Modifier -50 to These Auditory Codes
Bilateral approval can boost cochlear implant rates Your otolaryngologist can now offer co... Read more
HCPCS Issues New Inhalation Solution Codes
Replace your albuterol/levalbuterol J codes; delete blood-draw G code Your 2005 superbill... Read more
2 Components Don't Necessarily Justify Billing 99215
Better way: Let the problem drive your E/M code selection When claiming 99215 based on a ... Read more
These Patient Profiles Signal 99215 Territory
Look for high-level visit documentation with cancer/neuroma patients To avoid undercodin... Read more
Reader Questions:
Bill 70371 for Radiological Strobe Interpretation
Question: In addition to assigning 31579 for laryngoscopy with stroboscopy, we also report... Read more
Reader Questions:
Code Follow-up ED Patient as Established
Question: An otolaryngologist saw a patient whom our ENT group had never previously treate... Read more
Reader Questions:
30465 Includes Suspension Method
Question: Which CPT code should I use for nasal valve suspension? Wisconsin Subscri... Read more
Reader Questions:
'Noncontributory' Implies Nonapplicable
Question: I lose audit points when I use the term "noncontributory" for any portion of ROS... Read more
Reader Questions:
Documentation Is Key With Failed Mirror Exam
Question: May I report a comprehensive otolaryngology exam if I perform a mirror examinati... Read more
Reader Questions:
Don't Lose Money With Wrong Trach Code
Question: When an otolaryngologist performs a tracheostomy with a Bjork flap or inferior t... Read more
You Be the Coder:
Sort Out 3 Post-Op Period Modifiers
Question: An otolaryngologist performs two tympanoplasties at different sessions for the s... Read more
These Clues Help You Distinguish Between Aspiration and Biopsy
Key: Bill FNA for fluid/cell sampling and PNB for tissue collection If you report an otol... Read more
1 Easy Way to Keep FNA and PNB Straight
Determine aspiration or biopsy with a glance at this chartSeven clues can help you zoom in... Read more
How to Ensure Modifier -25 Appeals Are Worth Your Time
HIPAA, CPT guidelines may convince insurer to pay up The next time you don't know what to... Read more
News Brief:
2005 Fee Schedule Delivers Mixed Bag to ENTs
Although otolaryngologists will benefit from Medicare's slight rate hike in 2005, your tot... Read more
Reader Questions:
2 Codes Describe Airway Obstruction
Question: Could you please help me with an ICD-9 code for concha bullosa? I have been se... Read more
Reader Questions:
69540 Requires Tube Removal
Question: How should I code for tympanostomy tube and aural polyp removal under general an... Read more
Reader Questions:
Include In-Office Collection Work in E/M
Question: When an otolaryngologist tests a patient for respiratory syncytial virus (RSV) i... Read more
Reader Questions:
Bill Medication, Not Supply With Pulmonary Codes
Question: May an otolaryngologist's office bill methacholine in addition to the bronchospa... Read more
Reader Questions:
Extra Step Changes 21315 to 21320
Question: When choosing between 21315 and 21320, what are acceptable forms of stabilizatio... Read more
Reader Questions:
NCCI Isn't Only Correct Coding Guide
Question: An otolaryngologist reported 12042 and 38542. Is that an appropriate combination... Read more
You Be the Coder:
How to Report Routine Postsurgical Observation
Question: Our otolaryngologist performs tonsillectomies and adenoidectomies (T&As) as ... Read more
Do You Need Help Coding Botox Injections? Expect Varied Responses
Surprise: 64999 is the only correct option Don't let mixed advice on reporting a Boto... Read more
Your Vocal Cord Injection Claims Could Contain 2 Related Items
Careful medical-necessity documentation will help win EMG payment When your otolaryngolog... Read more
3 Surefire Steps You Need to Avoid Tonsil/Adenoid Removal Miscodes
"Secret: You can use 42820, 42821 as universal T&A codes If you don't know when a pati... Read more
Correction:
Audiologist - Not ENT - Performs Tinnitus Matching
The December 2004 Otolaryngology Coding Alert article "These 3 New Codes Help You Avoid ... Read more
CPT 2005 Update:
New Descriptors for 94060 and 94070 Fine Tune Bronchospasm Coding
When you report 94060 in 2005 for your allergist's bronchospasm evaluation services, you'l... Read more
Know Which Services Your NPs Can Report
Ask payers about direct versus personal supervision for allergy tests When your allergis... Read more
Clip-and-Save Chart:
Need Answers to Xolair Coding Questions? Look No Further
Trace your way to the right injection code for Medicare, private carriers If your allergy... Read more
Master 5th-Digit Coding to Improve ICD-9 Accuracy
If you're submitting CPT codes with three-digit diagnosis codes linked to them - such as 4... Read more
Check Your Charts for E/M Support, Consult Accuracy
Why 'significant' and 'separate' matter when you're using modifier -25 Payers are denyin... Read more
Reader Questions:
69990 No Longer Refers to OM Use
Question: I receive frequent denials for 69990 (ear examination with operating microscope ... Read more
Reader Questions:
Initial Consult May Lead to Additional Consult, Care
Question: When an otolaryngologist performs an inpatient consult, I bill 9925x. Should I c... Read more
Reader Questions:
Replace 92589 With Time-Specific Code(s)
Question: I received a denial for 92589 with service date of Jan. 5. Should I appeal the d... Read more
Reader Questions:
Use Modifier -57 Exclusively on E/M Codes
Question: May I append modifier -57 to a surgical code as you suggest in the November 2004... Read more
Reader Questions:
Here's How to Appeal Turbinate Denials
Question: Aetna denied the following charges: 42831, 30802. The insurer paid for 42831 but... Read more
Reader Questions:
'Supple' May Refer to These Systems
Question: When my otolaryngologist writes "Neck is supple," should I count the phrase as p... Read more
Reader Questions:
Report Rhinolaryngoscopy as 1 Scope
Question: Which CPT codes should I submit when an otolaryngologist performs diagnostic rhi... Read more
Reader Questions:
Combine Physician Work for Same-Day Visit
Question: If two allergists in the same group see the same office patient on the same day,... Read more
Reader Questions:
Look to Separate Code Set for Stinging Insect Venoms
Question: We are having problems getting reimbursed for allergy injections for stinging in... Read more
Reader Questions:
Use Hours to Report 95180 Multiples
Question: How should I bill for 95144 at three vials and 95180 at eight injections? Also, ... Read more
Reader Questions:
Don't Confuse Spirometry and PFT
Question: We perform pulmonary function tests (PFTs) on an outpatient basis at the hospita... Read more
Reader Questions:
Report 95165 for Allergen Prep, Supervision
Question: When our physician writes a prescription for 10 doses of allergen immunotherapy,... Read more
You Be the Coder:
2 Ways ICD-9 2005 Revises 250.xx
Question: An otolaryngologist diagnoses hearing loss due to neurological deterioration in ... Read more
You Be the Coder:
What to Do About Probable Diagnoses
Question: A pediatric patient with asthma symptoms comes to our practice for the first tim... Read more
Available Years:  2005  2004  2003  2002  2001  2000  1999