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Otolaryngology Coding Alert

CPT® 2017:
Latest CPT® Edition Offers New Code for Injection Laryngoplasty
Changes could impact your reimbursement. The New Year is just around the corner, and w... Read more
Benchmarking:
Does Your PA's Modifier 25 Use Make the Grade?
Hint: Know your global periods. Your physician assistant is probably an integral part ... Read more
ICD-10 QUIZ:
Evaluate Your ICD-10 Know-How With This Quick Quiz
These ENT-specific scenarios will help you gauge your knowledge. You’ve been rep... Read more
5 Quick 99211 Facts Help Guide Your Level 1 Coding
Hint: This code only applies to established patients. Code 99211 might be your go-to c... Read more
Patient Privacy:
Is Your Practice Texting in Line with HIPAA Standards?
Ensure that you’re protecting yourself and your patients when you text. Mobility... Read more
Reader Question:
Know When, How to Amend Notes
Question: Our office performed an audit prior to submitting our claim to insurance ... Read more
Reader Question:
Consider Type of Telemedicine When Choosing Code
Question: Often, one of our otolaryngologists or qualified nonphysician practitione... Read more
You Be the Coder:
Get the Right Code for Drainage of a Nasal Abscess
Question: A provider aspirates the excess fluid from an abscess within the nasal ca... Read more
Coding Eustachian Tube Testing Isn't Always a Precise Science
No code? No worries with this helpful advice. When a patient presents to your ENT offi... Read more
E/M Coding:
Can You Find the Problem With This E/M Chart?
Don’t make the same mistakes as this practice did—keep collecting for your E... Read more
Family Visits:
Discussing Patient's Care With Family? E/M Might Still Apply
As long as the patient is present, CMS allows you to bill an E/M code based on time. I... Read more
Reader Question:
Medicare Isn't the Only Auditor
Question: We treat pediatric patients who require otolaryngology care, so we don&rs... Read more
Reader Question:
Differentiate Laryngitis Types
Question: Which code should we report for laryngitis? Codify Subscriber Answer:... Read more
Reader Question:
Incidental Trach Is Not Billable
Question: We performed a tracheostomy during a laryngectomy and received a denial f... Read more
You Be the Coder:
Personalize Your Compliance Program
Question: Our practice bought a compliance plan from a consultant about eight years... Read more
Benchmarking:
Examine Your Coding Trends With a Benchmarking Study
Know exactly where your ENT practice stands by performing a code comparison. Have you ... Read more
Clip And Save:
Here's Your Breakdown of Which Codes Otolaryngologists Are Reporting Nationally
Once you compare your practice’s benchmarking data over time, you may want to take... Read more
ICD-10 Quiz:
Test Your Diagnosis Coding Skills With This Quick Quiz
From A codes to Z, we’ve got the ICD-10 answers you need to ensure quick claims pa... Read more
Reader Question:
Watch Your Modifiers for VNG Testing
Question: Can we bill independently under the audiologist for VNG testing done in t... Read more
Reader Question:
Let the Approach Guide Your 30117 vs. 30118 Choice
Question: Our surgeon performed wide local excision of a nasoseptal lesion, with un... Read more
Reader Question:
You Can Stop Looking for 'Admit' Code
Question: Our otolaryngologist admitted a patient to the hospital and asked the cod... Read more
Reader Question:
Know the 31295 Bundling Rules
Question: We performed an endoscopic lavage along with 31295 (Nasal/sinus endoscopy... Read more
You Be the Coder:
Verify Details Before Reporting a History of Cancer
Question: An established patient with a history of nasopharyngeal cancer was seen i... Read more
Medicare Payments:
CMS Signals Potential Changes to Modifier 25 With These ENT Services
The 2017 proposed Fee Schedule could make payment for E/Ms with select minor procedures ... Read more
Compliance:
WPS Medicare Identifies This Major Coding Problem Among ENTs
Hint: Don’t skimp on documentation. Most coding experts have heard the old adage... Read more
ICD-10:
Get Your Documentation in Order Before Coding Obstructive Sleep Apnea
The 2017 proposed Fee Schedule could make payment for E/Ms with select minor procedures ... Read more
Reader Question:
Extent of Service Separates Tympanostomy from Myringotomy
Question: A patient came in for bilateral pressure equalization tube placement. The... Read more
Reader Question:
Meet These Criteria Before Reporting 31231 With 31575
Question: The otolaryngologist performed endoscopy in our office and reported 31231... Read more
Reader Question:
Submit 21499 for Styloidectomy
Question: The surgeon resected the patient’s right styloid process. What code... Read more
Reader Question:
Make Sure One System Is Marked for 'All Others Negative'
Question: Our otolaryngologist always marks “all others negative” in th... Read more
You Be the Coder:
Include Modifier 52 for 92550 on One Ear
Question: I have two questions about code 92550. Can we only use it when ipsilatera... Read more
Throat Procedures:
Here's How to Report Botox A to Treat Spasmodic Dysphonia
Tip: Pay special attention to reporting drug wastage. Spasmodic dysphonia (also known... Read more
Ear Focus:
Code Correctly for These 3 Common Ear Procedures
Start by digging into descriptors to better understand the service. Myringoplasty, tym... Read more
ICD-10:
Associated Eye Symptoms Point You to the Correct Sicca Syndrome Code
‘Keratoconjunctivitis’ note will make the difference. Sicca syndrome (also... Read more
Reader Question:
Follow This Guide for Sequencing Sinus Surgeries
Question: I could use some help in correct coding and sequencing for sinus surgery.... Read more
Reader Question:
Using Endoscope Doesn't Change Septoplasty Code
Question: I am still new to the coding world and need to code for an endoscopic sep... Read more
Reader Question:
Stay Away From Considering 21025 for Bilateral Modifier
Question: One of our otolaryngologists wants to bill 21025 bilaterally with modifie... Read more
Reader Question:
Rely on the CCI Explanation for 60500 Bundling Into 60240
Question: Can you help me explain to my physician why CPT® 60500 bundles into 6... Read more
Reader Question:
MUE of '1' Means You Report 31535 Only Once
Question: My understanding of 31535 is that I code each time for a biopsy that was ... Read more
You Be the Coder:
Correctly Report Both Anterior and Posterior Packing
Question: My doctor states that he did both anterior and posterior packing for epis... Read more
ICD-10:
October Will Bring Your First Official Updates to ICD-10
Look for expanded options for hearing loss, tinnitus, and more. Just as you’ve b... Read more
New Code Check-In:
Be Sure You Know How to Handle Drug-Eluting Stent Coding
  Start with a solid understanding of when they’re necessary. CPT® 20... Read more
Reader Question:
Code 92550 Covers Both Ipsilateral and Contralateral Reflexes
Question: Does code 92550 only apply when ipsilateral and contralateral reflexes ar... Read more
Reader Question:
Work of 60240 Includes Work of 60500
Question: Can someone help me explain to my physician why CPT® code 60500 bundl... Read more
Reader Question:
Learn the Ins and Outs of App Privacy
Question: Our clinicians are using more and more apps for a variety of reasons, inc... Read more
Reader Question:
Verify Approach Before Assigning Submandibular Drainage Code
Question: Our surgeon recently performed drainage of an abscess in the submandibula... Read more
Reader Question:
Submit 'Unlisted' 92700 for VEMP
Question: I am trying figure out the best CPT® codes to use for a Dix-Hallpike ... Read more
Reader Question:
The Work of 30905 Includes 30901
Question: My doctor states that he did both anterior and posterior packing for epis... Read more
Reader Question:
Keep Up With What OIG Is Watching
Question: I know that different reports come out periodically to show the issues or... Read more
Reader Question:
Let Work, Not Follow-Up Designation, Guide E/M Code Choice
Question:  Our physician recently saw a patient because of an abscess on her neck. ... Read more
You Be the Coder:
The Best Code for Lysis of Tonsil Adhesion
Question: A tonsillectomy patient now has a piece of skin adhered to the uvula. The... Read more
Procedure Focus:
Trying to Capture Trach Tube Changes With E/M Codes? Here's How.
Tip: Get clear documentation of the complaint. According to coding guidelines, 31502 (... Read more
Allergy Tests:
Check Your Answers to 3 Common Allergy Questions to Keep Claims on Track
Plus: Watch for opportunities to include E/M with the allergy care. Pollen coated surf... Read more
ICD-10:
Dig Into the Options for Lymphadenopathy and Lymphadenitis
The terms are not interchangeable. If a patient sees your otolaryngologist because of ... Read more
Reader Question:
Encourage Providers to Document Laterality for More Accurate Dx
Question: Our provider diagnosed a patient with recurrent otitis media and chronic ... Read more
Reader Question:
Audiologist Must Have Her Own NPI for Billing Purposes
Question: How do I bill for an audiology service if the audiologist hasn’t ye... Read more
Reader Question:
Avoid Consultation Codes on Medicare Claims
Question: I have a denial for 99253 from Anthem Senior Advantage stating that this co... Read more
Reader Question:
Implanted Device Does Not Equal Foreign Body
Question: What is the correct ICD-10-CM code for a retained and malpositioned T-tub... Read more
Reader Question:
Think Anatomic Site, Then Addition, for Lesion Excision Coding
Question: I’m coding for two separate malignant lesions on the scalp. Do I ad... Read more
You Be the Coder:
File This for Flex Laryngoscopy With Meds
Question: I’ve not found any information about reimbursement for 31599. Consi... Read more
Coding Edits:
Newest CCI Pairs Bundle IV Infusions With Thousands of Procedures
But – The changes won’t alter your coding much. The latest version of Corr... Read more
Clip N Save:
Let This Chart Help You Keep Inferior Turbinate Codes Straight
Now it’s easy to know how to report each procedure.  ... Read more
Procedure Focus:
Remember 3 Checkpoints for Inferior Turbinate Procedures
Plus: Here’s how to handle middle turbinate coding. The nose has three turbinate... Read more
ICD-10:
Stick With a Single Code for Unspecified Sensorineural Hearing Loss
The updated descriptor is basically the same. One diagnosis that hasn’t had much... Read more
Reader Question:
Choose 69220 for Cholesteatoma Debridement
Question: Our physician debrided a cholesteatoma in the external ear canal. How is ... Read more
Reader Question:
Study Options for Post-Tonsillectomy Hemorrhage Diagnosis
Question: I am having difficulty finding the appropriate ICD-10 code for post-tonsi... Read more
Reader Question:
Mine the Details Before Coding Co-Surgery
Question: I am receiving denials for code 62165 endoscopic pituitary tumor excision... Read more
Reader Question:
Laterality and Approach Determine PCS Code for 69436
Question: I can’t find the 2016 ICD-10 PCS code for 69436. Can you help? We... Read more
Reader Question:
Thorough Documentation Can Help Battle Endoscopy Denials
Question: Some of our physicians have been receiving denials for not documenting na... Read more
Reader Question:
'Diagnostic' Is the Key to Submitting Multiple Scopes
Question: The otolaryngologist performed a direct laryngoscopy, direct bronchoscopy... Read more
You Be the Coder:
Coding Grafts During Tympanoplasty
Question: I am confused on the graft codes during tympanoplasty. I know the graft i... Read more
Audiology:
Follow 3 Steps to Successful ENG Claims
Verify the correct number of codes to include. An otolaryngologist or audiologist will... Read more
Procedure Refresher:
Do You Know What Happens During ENG?
Understanding a procedure helps you code it better. An ENG is used to detect disorders... Read more
E/M Coding:
Test Yourself: How Would You Report This Multi-Visit Claim?
Remember that office visit coding isn’t always cut-and-dry. Pinpointing the corr... Read more
ICD-10:
Are You Using All Your Options for Sialoadenitis Coding?
Don’t forget you have 4 diagnoses now. When the otolaryngologist diagnoses sial... Read more
E/M Coding:
Test Yourself: How Would You Report This Multi-Visit Claim?
Remember that office visit coding isn’t always cut-and-dry. Answer: In the scena... Read more
Reader Question:
Add Modifier 59 to Your 31295/31000 Claim
Question: Can you bill 31295 for maxillary sinus balloon dilation with 31000 for la... Read more
Reader Question:
Including Bilateral Modifiers With Nasal Endoscopy Codes
Question: Can the nasal endoscopy codes 31255, 31295, and 31297 be used with modifi... Read more
Reader Question:
Check Out H69.8~Family for Eustachian Tube Dysfunction
Question: Eustachian tube dysfunction had a specific code in ICD-9, but I haven&rsq... Read more
Reader Question:
No Payers Allow a Claim With 21325 and 30520
Question: We submitted a claim with codes 21325 and 30520. The insurer denied ... Read more
Reader Question:
Payer Could Be the Reason Behind 21012 Denial
Question: We’ve submitted two claims for 21012 performed in our office (for t... Read more
Reader Question:
Submit 42950 for Uvulopharyngoplasty
Question: Our otolaryngologist performed a lateral pharyngoplasty, then he excised ... Read more
You Be the Coder:
Verify the Dividing Line Between 21554 and 21556
Question: The otolaryngologist performed an open excision of a 3 cm tumor located i... Read more
Nosebleed Care:
Check the Technique Before Submitting 30901 for Repair
Plus: Don’t forget you have different codes for posterior bleeds. A patient come... Read more
E/M Coding:
Follow 4 Solid Tips to Overcome Observation Obstacles
Watch the dates to hone in on the correct code. Physicians often admit patients to a h... Read more
ICD-10:
Choose Between Two Codes for Unspecified Benign Neoplasm of Mouth
Pay attention to ‘other’ versus ‘unspecified’ distinction. If ... Read more
Reader Question:
Only Submit 64490 With 69436 When Medically Necessary
Question: My patient’s tube went into the middle ear. The physician took her ... Read more
Reader Question:
Check for Green Light With Multiple Endoscopy Codes
Question: Can codes 31255, 31295, and 31297 be used with modifier 50? Can they be r... Read more
Reader Question:
Don't Assume All Facial Lymph Node Excisions Are Superficial
Question: Our physician wants to bill 38500 for a deep lymph node excision of the c... Read more
Reader Question:
Choose Two Codes for Different Hearing Loss in Each Ear
Question: ICD-9 code 389.16 crosses over to H90.5 in ICD-10, but my physician says ... Read more
Reader Question:
Include a Modifier to Report 69801 With 99213
Question: Is it possible to bill an office visit code such as 99213 with a steroid ... Read more
You Be the Coder:
Look Here for Eustachian Tube Obstruction
Question: Eustachian tube dysfunction had a specific code in ICD-9 (381.81), but in... Read more
CCI 22.0:
Update Your Systems to Reflect the Latest Coding Edits
Pay special attention to cerumen removal services. With more than 57,000 Correct Codin... Read more
Education:
Teaching Patients About Asthma Could Count as Prolonged Service
Here’s your guide to E/M documentation success. Wintertime can be difficult for ... Read more
E/M Coding:
Refresh Your Knowledge of Codes 99415 and 99416
Don’t forget these other prolonged service options. As you adjust to the newest ... Read more
ICD-10:
Don't Cross Codes for Acute and Chronic Tracheitis
You still have only one code for acute patients. Acute tracheitis is one condition yo... Read more
Reader Question:
Don't Fall in the 'Same Group Physicians/Separate E/M' Trap
Question: Two otolaryngologists in our practice treated a patient twice on the same... Read more
Reader Question:
Get Physician Perspective on the Best LPR Diagnosis Code
Question: What is the best diagnosis code for laryngopharyngeal reflux (LPR)? Ala... Read more
Reader Question:
Be Wary of Thyroidectomy/Parathyroidectomy Edit Bundles
Question: I know that the parathyroidectomy and thyroidectomy are incidental to eac... Read more
Reader Question:
Submit 'Unclassified' for Restylane
Question: Can you help me with the correct code to use for Restylane billing? I nee... Read more
Reader Question:
Include Modifier 59 for Multiple FNAs to Different Sites
Question: What is the proper way to code 10021 for a fine needle aspiration on the ... Read more
You Be the Coder:
Remember the Difference Between Chronic Rhinosinusitis and Chronic Sinusitis
Question: One of our payers has a new FESS (Functional Endoscopic Sinus Surgery) po... Read more
Office Procedures:
Keep 3 Points In Mind Before Coding Scopes With E/M
Hint: Get all your documentation straight first. Although your otolaryngologist knows ... Read more
2016 CPT® Updates:
Remember to Add New Endoscopic Codes to Your Mix in 2016
Check whether you can report these sinus implants. CPT® already includes a fair nu... Read more
Modifiers:
Brush Up on When 62 Fits for Co-Surgery
Be sure to match both surgeons’ codes. Otolaryngologists sometimes perform surge... Read more
ICD-10:
Add 'Unspecified' to Your Acute Pharyngitis Descriptor
One word is the only difference between old and new. When you still reported diagnoses... Read more
Reader Question:
Dig for Injury Date if Scrubber Requires It
Question: Our claim scrubber is kicking out claims for removing foreign bodies from ears... Read more
Reader Question:
Photographs Aren't Needed to Support Stroboscopy
Question: What type of documentation is required for physician to be reimbursed for perf... Read more
Reader Question:
Submit 30801 With 31240 and Clear Documentation
Question: I am trying to understand the reasoning behind bundling 30801 with 31240. My s... Read more
Reader Question:
Let Anesthesia Guide Tympanostomy Code Choice
Question: My physician placed a ventilation tube in an eardrum but did not perform a myr... Read more
Reader Question:
Verify With Workers' Comp Before Using ICD-10
Question: I’ve heard that we shouldn’t use ICD-10 for workers’ compens... Read more
You Be the Coder:
Check This When Deciding Between CPAP or E/M
Question: A patient underwent a sleep study and came to our office afterwards for an eva... Read more
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