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Otolaryngology Coding Alert

Good News:
CPT 2009 Sets New Code in Stone for Epley
Say goodbye to those tricky temp or -S- codes. Jumping through the hoops to seek reimbu... Read more
Code 99070 When Encounter Meets 5 Requirements
This checklist will get you charging supplies without unbundling. Before you accept ano... Read more
Bypass Septoplasty Global By Sidestepping Modifier Mishaps
You have 3 tools to relate look-see, E/M to FESS. If endoscopy and office visit denials... Read more
READER QUESTIONS:
May We Use This Lab Code?
Question: One of our doctors would like to know whether we might bill 88380 (laser) with... Read more
READER QUESTIONS:
Clear Up Inhaler Code Confusion
Question: A patient required three nebulizer treatments in the office to control her acu... Read more
READER QUESTIONS:
Shared Surgery Signals Same Code With 62
Question: A neurosurgeon performs craniectomy with an otolaryngologist for the excision ... Read more
READER QUESTIONS:
Do I Need a 5th Digit for Asthma Dx?
Question: When reporting an asthma diagnosis, do I need a fifth digit? Washington Subsc... Read more
You Be the Coder:
Anatomical Term Reveals Site of Lesion
Question: What is the correct coding for this situation? The physician injected the pati... Read more
Focus on Cyst Location to Reel In Proper Excision Pay
Mixing up branchial and preauricular cysts can put you in the wrong CPT section. Unless... Read more
Code Preauricular Cyst Excision Using 1, 2, 3 Closure Rules
You-ll sometimes use one skin code -- and other times two. Since no site-specific code ... Read more
3 Answers Remove Roadblocks to CMS Audiology Compliance
Find solutions to just-discovered logistical problems. It's been a tumultuous nine mont... Read more
READER QUESTIONS:
2 Membranes = 1 Code
Question: During tube removal (69424), our otolaryngologist repaired the tympanic membra... Read more
Reader Questions:
Does 'Incident to' Apply to Inpatient Consults?
Question: How do you code a nonphysician practitioner report of a consultation that she ... Read more
Reader Questions:
Fix Middle Ear Surgery Reimbursement Leak
Question: My physician performed a tympanoplasty with mastoidectomy. During the surgery,... Read more
Reader Questions:
'Incident to' Is the Key to FEES Aid
Question: Our office is considering fiberoptic endoscopic evaluation of swallowing (FEES... Read more
Reader Questions:
Don't Expect to Collect for 42825 With 42145
Question: Why do insurance companies bundle UPPP (42145) with a tonsillectomy (42825) wh... Read more
Reader Questions:
Correctly Report Your Antigen Units
Question: What's the acceptable number of units to bill for allergy vials for Medicare p... Read more
You Be the Coder:
Can You Code E/M From This Referral?
Question: A family practitioner sent a patient to my ENT to remove a skin lesion. The EN... Read more
Focus on Provider, Nerve to Break Parotid/Mastoid-Monitoring Bundle
Audiologist ongoing auditory nerve testing falls under CMS direct-billing mandate With ... Read more
Check Nerve, Time, Equipment Before Reporting Monitoring Combo
Surprise: Modifier 26 in the facility isn't a shoe in Your monitoring claim will be inc... Read more
Start Using Time to Up E/M With These Tips
Parents-only counseling can be 99214, per CPT You-ve got a nifty tool to capture higher... Read more
READER QUESTIONS:
Rhinoplasty Versus Nasal Fracture
Question: An operative report describes a performed procedure as "open reduction of nasa... Read more
Reader Questions:
Include Clotting Aid in 42820-42821
Question: Doctor performed a T&A and placed Vitagel tissue seal over the adenoid and... Read more
Reader Questions:
Handcock Not Required on Orders
Question: Our otolaryngologists sometimes order hearing tests by phone to the audiologis... Read more
Reader Questions:
Check If FESS Switches to Open
Question: A patient has a large mass growing from the sinus that actually goes into the ... Read more
Reader Questions:
Look for Prosthesis When Coding Tymp
Question: An otolaryngologist enters the middle ear through a canal skin flap, removes d... Read more
You Be the Coder:
Post-Thyroid Removal, Thyroidectomy
Question: A patient who had a thyroidectomy seven years ago due to cancer returns for a ... Read more
Bust 2 Myths That Could Make You Leave Postop Scope Dollars on the Table
Your endoscopy coding needs an overhaul if you get these answers wrong Get the lowdown ... Read more
ICD-9 Update:
Indicate Fracture Hx to Support Nasal Repair
You-ll need only one code to report MRSA this fall Your struggle for medically necessar... Read more
Escape Incident-To Repays With Authorizing Note
When criteria aren't met, switch to NP's NPI from MD-s You can protect your ENTs from i... Read more
READER QUESTIONS:
Treat Clinic as Office for Supervision
Question: I work in a clinic located in a hospital building. Can a nurse run an allergy ... Read more
Reader Questions:
Check for 'Impacted' Before Billing 69210
Question: Is it appropriate to bill 69210 when cerumen is not considered impacted? For i... Read more
Reader Questions:
Meet 2 Qualified Audiologist Requirements
Question: We have a licensed audiologist in our office, and I have applied for her NPI a... Read more
Reader Questions:
Look at Trach Status When Coding Repair
Question: A patient had a long-term trach removed, but a scar remains. The otolaryngolog... Read more
You Be the Coder:
Myringotomies, T&A: How Many Codes?
Question: Part of an operative note reads: Operation: "Bilateral myringotomies with Arm... Read more
Catch Often Missed Billable FESS Procedures Using 5 Tips
A 30465 light bulb should go off when you see -stenosis- You don't have to be a super s... Read more
Spot Sinus Landmarks to Unravel Op Reports
Tear out: Your FESS anatomy crosswalk reveals capturables Trace your otolaryngologist's... Read more
Modifier Quiz:
Save 76 for True Repeat or Risk Overpayment
Modifier 59 might apply even when you use the same code You could mislabel a modifier 5... Read more
Correction:
Put NPI in 24J on CMS-1500
You should enter the National Provider Identifier (NPI) in box 24J, not 26J. 2008 Otolary... Read more
Opt for 787.20 When Phase Not Indicated
Question: A patient with nasopharyngeal carcinoma S/P radiation and chemo has subsequent... Read more
Reader Questions:
Is 69436 Part of Middle Ear Surgery?
Question: When we submit 69436 with 69601, UnitedHealthcare (UHC) bundles the tube inser... Read more
Reader Questions:
Increase Risk When Note Shows This
Question: When using the table of risk, what determines the identified risk factors or n... Read more
Reader Questions:
Check 3 Items Before Bundling 30520
Question: In an operative report, the otolaryngologist describes performing a septoplast... Read more
Reader Questions:
You Have Another Chance to Join PQRI
Question: Our ENT practice is regretting that we did not begin the Physician Quality Rep... Read more
Reader Questions:
1 Answer Determines Modifier 80 Action
Question: Medicare is not paying for an assistant surgeon on craniotomies with removal o... Read more
You Be the Coder:
Tube Removal Coding Do's and Don'ts
Question: An otolaryngologist removes tubes in the office using the operating microscope... Read more
Stop on Higher-Paying Scope Code Minus Laryngeal Exam Indication
Anatomy paints picture of 92511, 31231 or 31575 territory You can net almost $100 more... Read more
Clinch Extra $100 in Diagnostic Pay With Scope Essentials
Anatomy and CC steer 31231 to 31575 selection You-ll avoid undercoding or overcoding y... Read more
End Fruitless HPI Rule Search With Inside Scoop
CMS does make this element your ENT's territory Your ENT isn't wasting his time confirm... Read more
Reinstate 'Old' J Codes to Get Claims Paid
You-re going to code rescue med supply based on drug -- again If you flagged J7611-J761... Read more
Reader Questions:
Oral Lesions: Check Method, Site
Question: An otolaryngologist plans on treating precancerous multiple mucosal lip lesion... Read more
Reader Questions:
Auditing: Count Otalgia HPI
Question: I-m auditing a note that states: "CC: A patient seen in the office complains ... Read more
Reader Questions:
Is Cochlear Device Implantation Bilateral?
Question: An otolaryngologist implants a cochlear device with mastoidectomy on both ears... Read more
Reader Questions:
Call on 24 for New Px at Post-Op Visit
Question: An ENT sees a patient in follow-up for a tympanoplasty (69436, Tympanostomy [r... Read more
Reader Questions:
Check Carrier's CRP Performer Rule
Question: Can I bill 92700 when an audiologist performs the Epley maneuver? Missouri Su... Read more
You Be the Coder:
Is 69424-69610 Bundle Appealable?
Question: An otolaryngologist places a paper patch (69610) on a patient's right ear and ... Read more
Op Note Coding:
Net $330 More in Functional Nasal Surgery Pay When You Spot 2 Items
Step-by-step guide points you to 30400-30450 key words When you see "bony pyramid" and ... Read more
Preauthorize 30400-30450 to Ensure ENT Gets Paid
New ABN is essential when rhinoplasty might be cosmetic All rhinoplasty patients underg... Read more
Avoid Losing $35 for 99212 Instead of 99242
Time-limit myth restricts consults on repeat patients If you use the three-year rule ac... Read more
Reader Questions:
Check Size, Removal for Needle Codes
Question: An otolaryngologist takes a percutaneous biopsy of the salivary gland. Should ... Read more
Reader Questions:
Solve 9923x Denials With Specific Dxs
Question: We-ve been receiving concurrent care denials for E/M services our otolaryngolo... Read more
Reader Questions:
Indicate Patient Failed 1st Screen
Question: A patient comes to us after failing a hearing screen, but passes our in-office... Read more
Reader Questions:
Opt for 99360 When Waiting Is All
Question: When my physician does a frozen section during a procedure, we normally bill 9... Read more
Reader Questions:
Which Modifier for Multiple I&D?
Question: Within the global of 10060, we have had to perform 10060 multiple times. Can I... Read more
Reader Questions:
Is NP-Run AI Clinic a Supervision Stickler?
Question: Our ENT supervises treatment board mixing on Saturday mornings. When our surge... Read more
You Be the Coder:
Is 31240 Plus Polypectomy OK?
Question: A surgeon plans a concha bullosa resection. The patient's nasal passage is so ... Read more
Route Test Pay to Your ENT Group in 3 Easy Steps
This paperwork gets the numbers you need to report AuD work You can ensure that benefit... Read more
Get the Right OV-Consult Code Mix
Returning a patient puts you on the 9924x path When you-re coding new patient office vi... Read more
Realize the Role Technicians Can Play
Vestibular tests will require beefed-up notes If your audiology technician's notes indi... Read more
Keep CMS Audiology Test Pay Rolling in With This Direct Coding Primer
You can achieve NPI reportability using these insider tips If you think that meeting M... Read more
Reader Questions:
Use 11900 for Injection, Not Drug
Question: May I bill for Kenalog in addition to 11900? If so, how do I calculate the fee... Read more
Reader Questions:
69620 Includes 20926, but 69631 Might Not
Question: I-ve read and been told multiple times not to bill 20926 with 69620 due to the... Read more
Reader Questions:
Give Credit When History Is Unobtainable
Question: An otolaryngologist had to intubate a patient who was unconscious. What level ... Read more
Reader Questions:
TM Injection Falls Under 69801
Question: An otolaryngologist gave a transtympanic injection of a steroid for sudden hea... Read more
Reader Questions:
Use 2 Dxs to Support 31575 With E/M
Question: A patient came in for chronic ethmoid sinusitis that wasn't resolving. The... Read more
You Be the Coder:
Does Septoplasty Include Complication?
Question: An otolaryngologist billed 99282, 30520 and 30903 on day one. Three days later... Read more
Eliminate Pitfalls of Direct Vocal Cord Injection to Stop Endless Paperwork
Surprise: Your diagnosis -- not your CPT code -- might trigger denial If a small coding... Read more
Add Laryngeal Spasms to 64613 Covered Codes
Time-saver: Your comments could bring 478.75 out of the denial den Put an end to insure... Read more
Pinpoint Overlooked 64613-Related Charges
Watch out: Infacility LEMG requires modifier 26 Before you file another vocal cord inje... Read more
Score OM-to-Tubes MDM Like a Pro -- Here's How
This case study hones your section 3 auditing skills You can nail down all the score sh... Read more
Reader Questions:
Insurer Determines Interpreter Coverage
Question: What diagnosis code should I use with T1013 for using an interpreter? Ohio Su... Read more
Reader Questions:
Make Annual Hx Faster
Question: Do patients have to complete a yearly history and physical questionnaire? Our ... Read more
Reader Questions:
Zoom In on 3-Year Rule for New ENT
Question: A new ENT is coming over from a nearby county, and her patients will be joinin... Read more
Reader Questions:
MDs Are Immune to 61795 Bundle
Question: Will CMS start bundling 61795 into all endoscopic sinus surgery codes in April... Read more
You Be the Coder:
Nasal Fracture Treatment
Question: An otolaryngologist documents "closed reduction of nasal bone fracture." Shoul... Read more
Success Story:
Clinch $80+ for Concha Bullosa Work With 4 Tactics
One biller is now receiving fewer denials due to appeals letters A little effort can go... Read more
Appeals Tool:
Paint a Picture to Overturn 31240-59 Denials
Diagram shows adjudicator separate sites A picture's worth a thousand words -- and migh... Read more
Tally Your Risk the Way the Auditors Do
5 must-have answers aid MDM choice You can quantify your internist's medical decision-... Read more
Update:
Include 61795 in ASC Sinus Surgeries for 2008
CMS changes status to N1 -packaged service- You cannot, unfortunately, report stereotac... Read more
Reader Questions:
Find Hyoid Code in Neck Subsection
Question: How should I code for "hyoid suspension" due to obstructive sleep apnea? I was... Read more
Reader Questions:
Does 78 Reset Global Period?
Question: I used modifier 78 for a return trip to the operating room to control bleeding... Read more
Reader Questions:
Does Discount Apply to Different Areas?
Question: Our four ENTs have a coding problem with outpatient surgery for a septoplasty ... Read more
Reader Questions:
Propellant-Driven Inhaler Falls Under 94664
Question: Should I use 94664 for education/training with the Advair diskus? Our allergis... Read more
Reader Questions:
Go to AA to See if Assistant Is Allowed
Question: How do I find out if I can bill a procedure with an assistant surgeon? Washin... Read more
Reader Questions:
Combat Denials With E/M, Scope Sections
Question: Insurers keep bundling 9921x-25 into 31575, even when I use separate diagnoses... Read more
You Be the Coder:
Is 31237 a Billable Post-Op Procedure?
Question: An otolaryngologist performed bilateral endoscopic sinus debridement for chron... Read more
Evaluate Your Top Procedures in Light of the New Open-Door ASC System
We made it easy to compare costs on 37 now-ASC-eligible -office- procedures Your practi... Read more
Give Your ENTs the ASC Financial Information They Need
Create your POS move analysis in just 4 steps Armed with a list of your practice's top ... Read more
Put Consultation Request to This 2-Prong Test
These details make -transfer of care- black and white You-ve been on the fence for two ... Read more
Clip and Copy:
Gain Extra $33 for 99243 Without Fearing Paybacks
This consult request form eliminates transfer-of-care concerns When a physician sends y... Read more
Reader Questions:
When Does Post-Op Period Start?
Question: The otolaryngologist performed a tonsillectomy on a 14-year-old patient. The p... Read more
Reader Questions:
Breathe Easy on 2008 CF -- for Now
Question: What is the conversion factor for 2008? North Carolina Subscriber Answer: ... Read more
Reader Questions:
Appeal Concha Bullosa Edit With Ammo
Question: I-m having trouble with 31240 being bundled with 31255. Do you have any sugges... Read more
Reader Questions:
Code E/M-25 and Allergy Test
Question: Can I bill an E/M service on the same day as an allergy test? Virginia Subscr... Read more
You Be the Coder:
Septoplasty With FESS, Turbinoplasties
Question: Which CPT codes should I submit for the following operation: Septoplasty. Nasa... Read more
CPT 2008 Update:
Get Comfortable With Staged Modifier When ENT Anticipates 2nd Surgery
Revised language should stop modifier 58 and 78 mixups You won't have to take a leap of... Read more
Take Advantage of Added Telehealth Services
Phone services aren't just MD territory in 2008 Nurses billing phone calls, e-visits an... Read more
Reader Questions:
Find Apex Cancer Diagnosis
Question: Documentation shows an otolaryngologist took a biopsy from the tongue's apex. ... Read more
Reader Questions:
99211 Requires This Type of Contact
Question: Should our otolaryngologist report 99211 when she reviews labs/x-rays, etc., a... Read more
Reader Questions:
Tube Removal + Placement = 1 Code
Question: Is there a code that insurers will pay for removal of a tube from the ear and ... Read more
Reader Questions:
Try ROS, PFSH Status Statement
Question: Ancillary staff record review of systems (ROS) and patients- past family socia... Read more
Reader Questions:
Check Payer's Tonsil Ablation Policy
Question: A surgeon performs a partial removal of the palatine or other tonsils with a C... Read more
You Be the Coder:
What Does 31276 Involve?
Question: The otolaryngologist uses a scope to inspect the frontal recess. While perform... Read more
Available Years:  2008  2007  2006  2005  2004  2003  2002  2001  2000  1999