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Otolaryngology Coding Alert

E/M 2023:
Prep for 2023 With These Consultation Coding Scenarios
And remember, not all payers accept consultation codes. With January right around the cor... Read more
Coding Quiz:
Can You Ace This 2022 Year-in-Review Coding Quiz?
How many of these major 2022 changes do you recall? Do you remember the important coding ... Read more
Compliance:
Establish a Strong Audit Program to Stay Ahead of the Curve
Hint: Scope helps establish your ‘why' and ‘how.' If you're happy with your practic... Read more
Coding Quiz Answers:
Check Your Answers to Our 2022 Year-in-Review Coding Quiz
Find out if your coding knowledge is up to date. Once you've answered the quiz questions ... Read more
You Be the Coder:
Consider These Codes for Concurrent Sinus and Flu Infections
Question: A patient with congestion, thick nasal drainage, facial pain, and a headach... Read more
Reader Questions:
Gain Insight Into Determining Audit Scope
Question: Our practice is working on creating a strong audit program, but we don't q... Read more
Reader Questions:
Have You Heard? HHS Renews PHE Again
Question: What is the current status of the PHE for COVID-19, and when can we expect ... Read more
Reader Questions:
Know What To Do With Audit Results
Question: We conducted a self-audit to make sure our ENT practice stays on the right ... Read more
E/M Updates:
Prepare for Consultation Coding Changes in 2023
Discover which code you'll use for straightforward MDM in lieu of 99241. Last month, Otol... Read more
ICD-10-CM:
Code Chemo Consequences in 6 Simple Steps
Learn to distinguish between adverse effect and poisoning. Sometimes, deciphering which I... Read more
Documentation:
Discover 3 Ways to Fortify Your Medical Records
Institute parameters for timeliness so important details aren't overlooked. Sloppy clin... Read more
Reader Questions:
Build a Foundation for Better Documentation
Question: Our practice wants to bill better, but staying up with regulations and changes i... Read more
Reader Questions:
Pinpoint Proper Reporting of Long COVID
Question: Our ENT documented that a patient has long COVID. Which ICD-10-CM codes should I... Read more
Reader Questions:
Choose Between ‘Unspecified’ and ‘Other’ Codes With Confidence
Question: What is the difference between H80.8- and H80.9-? Virginia Subscriber Answer... Read more
You Be the Coder:
Prevent Inpatient Consultation Claim Denials With This Advice
Question: I billed 99253 for an inpatient consultation on a Medicare patient performed by ... Read more
CPT® 2023:
Get Ready for Round 2: E/M Overhaul Complete
Widespread CPT® descriptor changes will impact otolaryngology coding in 2023. Practices ... Read more
Social Determinants of Health:
Enhance Your SDoH Documentation and Patient Care in 5 Easy Steps
Brush up on the new codes and related guideline changes. The 2023 ICD-10-CM code set int... Read more
ICD-10-CM Updates:
Find New Options for Long-Term Therapies, Noncompliance
Prepare now for more detailed Z79 diagnosis codes. Back in July, the Centers for Diseas... Read more
Reader Questions:
Preview Revisions to Bone-Anchored Hearing System Codes
Question: Our otolaryngology practice is trying to prepare now for all the upcoming c... Read more
Reader Questions:
Anticipate a Drop in Hearing Aid Prices This Fall
Question: Is it true that less expensive OTC hearing aids may soon be available and,... Read more
You Be the Coder:
Gear Up for Changes in Reporting Observation Services
Question: The otolaryngologist meets an established patient at the hospital with symp... Read more
Medicare Physician Fee Schedule:
Keep an Ear Out for These MPFS ENT Proposals
Expanded audiology access ahead but CF will likely decrease. Expect some give and take in... Read more
News You Can Use:
Consider These Crucial ICD-10-CM Revisions, Get a Head Start on 2023
Find expanded options for brain injuries, external causes, and more. If your patients ar... Read more
ICD-10-CM:
Find Answers to Your Top V Code Questions
Stay abreast of reporting transport accidents that cause injuries. The 2023 ICD-10-CM cod... Read more
Reader Questions:
Identify When to Code Swell Body Destruction Separately
Question: When our otolaryngologist performs nasal swell body (NSB) reduction on the ... Read more
Reader Questions:
Be on the Lookout for Medical Record Reviews
Question: Does our practice need to worry about medical record reviews by the Centers... Read more
You Be the Coder:
Know How, When, and When Not to Report NSB Reduction
Question: I received an operative report that said “b/l destruction of intranasal ... Read more
5 FAQs Help You Perfectly Code Every Ethmoidectomy
Hint: Ethmoidectomy may occur without an endoscope — but it's rare. If you come across ... Read more
ICD-10-CM Coding:
Can You Code Neoplasms of the Ear, Nose, and Throat?
These 2 examples help lead the way. Coding neoplasms of the ear, nose, and throat can pos... Read more
Surgical Coding:
4 Tips Help You Understand the Global Surgical Package Rules
Remember that modifier 54 must always accompany modifier 55. Although a surgical proced... Read more
Reader Questions:
Remember Modifier JW for Botox Injections
Question: Encounter notes indicate that the otolaryngologist performed a direct laryn... Read more
Reader Questions:
Don’t Stop at 1 Code for ENG
Question: Encounter notes indicate that the otolaryngologist performed an electronyst... Read more
Reader Questions:
Differentiate 17106 vs. 69145 for Ear Lesion Cauterization
Question: A patient presented with a left ear canal 0.5 cm vascular lesion. After deb... Read more
You Be the Coder:
Avoid H0033 for Tylenol Administration
Question: When one of our providers administers oral pain medication such as acetamin... Read more
Thyroidectomies:
3 Steps Help Clear Confusion When Coding Thyroid Lobectomies
Conflicting guidelines can be challenging to navigate when the physician uses a cervical a... Read more
Insurance Programs:
Get to Know 3 Essential Facts Before You Bill Tricare
Hint: You'll submit claims to Tricare before Medicaid, but after private payers. Whethe... Read more
ICD-10-CM Coding:
Could ‘Z’ Codes Be the Key to Your Claim Success?
These codes serve a more important purpose than you may understand. When it comes to dia... Read more
Reader Questions:
Patient Refuses to Pay? Follow These Steps
Question: A patient presented for his appointment and got belligerent when we showed ... Read more
Reader Questions:
Understand Your Claim Review Options
Question: Would it be more efficient, in terms of time and money, to review a percent... Read more
Reader Questions:
Check Unlisted for Snoreplasty Case
Question: How should I code radiofrequency reduction of the soft palate? Indiana Su... Read more
Reader Questions:
Differentiate Turbinate Injections
Question: My otolaryngologist injected a steroid into a patient's tympanic membrane.... Read more
You Be the Coder:
Can You Code This Critical Care Scenario?
Question: Our physician met an established patient with severe laryngeal bleeding in ... Read more
Ablation:
5 Facts About Coding Ablation Procedures for Rhinitis
Several major payers are implementing negative reimbursement policies for ablation when pe... Read more
Inpatient Coding:
Can You Answer These Inpatient E/M Coding FAQs?
Hint: Don't forget modifier AI when necessary. Whether your ENT is seeing hospital patien... Read more
Clip And Save:
Check Which Inpatient Codes Otolaryngologists Are Reporting Most Frequently
If you're getting to know the inpatient codes more closely, it might be a good idea to und... Read more
Substitute Physician:
Summer Is Approaching: Understand How to Report Locum Tenens Services
Don't let the NPI nuances slip your mind when billing for substitute physicians. With war... Read more
Reader Questions:
Understand HIPAA Compliance Rules
Question: Can we switch to gap analysis of how we implement HIPAA compliance instead of pe... Read more
Reader Questions:
Know This Nosebleed Coding Solution
Question: Our ENT provider performed simple anterior cautery on a patient's right nostril ... Read more
Reader Questions:
Understand What’s Included in Global Package
Question: Our surgeon performed a septoplasty (30520) and then, during the postoperative p... Read more
You Be the Coder:
Can You Spot the Problem in This Claim Submission?
Question: I submitted notes to my insurer multiple times, and they are continuing to deny ... Read more
Unlisted Codes:
3 Examples Guide You to Unlisted Coding Bliss
Hint: Never rely on “coding close” to a procedure code. If you've ever searched the C... Read more
Nurse Visit Coding:
Lock Down Your 99211 Coding Skills With a Few Quick Tips
Remember: The ‘nurse's code' was slightly changed last year. The income that nurses g... Read more
Part B Coding:
Part B Reps Share 2022 Coding Advice
Don't forget about the appeal timeline. From reporting split/shared services to moving fo... Read more
Reader Questions:
Understand the Alternatives to Modifier 59
Question: One of our otolaryngologists wants to bill 21025 bilaterally with modifier 50, b... Read more
Reader Questions:
Tonsillitis Code Isn’t One-Size-Fits-All
Question: A patient came to the office with a post-tonsillectomy hemorrhage. Should we app... Read more
Reader Questions:
Understand Nuances of Nasal Aspiration Codes
Question: One of our providers aspirated the excess fluid from an abscess that was within ... Read more
Reader Questions:
Understand Nasoseptal Lesion Coding
Question: Our surgeon performed wide local excision of a nasoseptal lesion, with underlyin... Read more
You Be the Coder:
Do You Know Why This Bundle Exists?
Question: Can you help me explain to my physician why CPT® 60500 bundles into 60240? He i... Read more
Surgical Coding:
3 Tips Help You Differentiate Hemi-Thyroidectomies From Completion Thyroidectomies
Hint: Completion thyroidectomies usually follow a previous surgery. Most ENT coders unde... Read more
Compliance:
Confirm Medical Necessity in Every Chart to Avoid Audit Scrutiny
Avoid the fate of this otolaryngologist, who could face decades in prison. Have you eve... Read more
Modifiers:
Clarify Partial Services With Modifiers 54, 26
Can you identify when the surgeon performs surgical or postop care only? Whatever the r... Read more
Reader Questions:
Can You Bill for Nasal Packing Removal?
Question: The ENT physician performed endoscopic control of a nasal hemorrhage and pl... Read more
Reader Questions:
Is Date of Injury Required?
Question: Our claim scrubber is kicking out claims for removing foreign bodies from e... Read more
Reader Questions:
Are Photos Required to report 31579?
Question: Are photos or videos required for us to justify reporting stroboscopy? If n... Read more
Reader Questions:
Should We Submit Nonreimbursable Claims?
Question: For a postoperative, related evaluation and management (E/M) visit within t... Read more
Reader Questions:
Look to K11 Series for Sialoadenitis
Question: Which diagnosis code describes sialoadenitis? Alaska Subscriber Answer: S... Read more
You Be the Coder:
Can You Pick the Right Modifier for This Scenario?
Question: Our otolaryngologist performed a myringotomy and we billed it with 69420- L... Read more
Tracheotomy Coding:
Confused About Trach Coding? Check These 3 FAQs
First, differentiate tracheotomy from tracheostomy. When your otolaryngologist is called ... Read more
Anesthesia Coding:
Dismantle One Key Myth Before You Report 92502
Make sure your exam requires anesthesia before submitting this code. Not every otolaryn... Read more
Medicare Enrollment:
Navigate 4 Provider Enrollment Scenarios With Ease
It's OK to appeal an enrollment decision, experts say. The Medicare enrollment process ca... Read more
Reader Questions:
Differentiate Otitis Media Terms to Find the Right Code
Question: I have an otitis media chart in front of me and I'm confused. I know it's ... Read more
Reader Questions:
Understand How to Differentiate 99050 From 99051
Question: When it comes to billing after-hours or evening codes, is it true that the... Read more
Reader Questions:
Understand How to Tally Supply Codes
Question: I'm very confused about the “J” codes that apply to allergy services. ... Read more
You Be the Coder:
Modifiers May Help Solve This Combo Procedure Conundrum
Question: Our ENT physician performed an endoscopy with concha bullosa resection (312... Read more
Compliance:
CMS: Otolaryngologists Logged 10 Percent Error Rate Last Year
ENT specialists were responsible for over $79 million in projected improper payments. Oto... Read more
Findout Which States Logged the Highest Error Rates
CMS and the Medicare Administrative Contractors (MACs) process claims from all 50 U.S. sta... Read more
Coding Edits:
Check out 4 MUE Facts That Will Help You Avoid Denials
Some coders remain confused about medically unlikely edits — but that's about to change.... Read more
Compliance:
HHS Cracks Down on Practices That Fail to Give Records to Patients
Make sure your practice isn't next to run afoul of the HIPAA Right of Access rules. Whe... Read more
Reader Questions:
Know How Medicare Calculates Payments
Question: Does the CPT® code determine the reimbursement rate or does the ICD-10 cod... Read more
You Be the Coder:
Understand When Each Modifier Applies
Question: Our otolaryngologist drained a peritonsillar abscess on December 1, and had... Read more
Incident-To Coding:
10 Tips Help You Straighten out the Incident-To Coding Rules
Hint: Only report incident-to services in the office setting — not in the hospital. Yo... Read more
Part B Payments:
Otolaryngology Pay Expected to Stay Flat in 2022
Plus: 2022 Final Rule also provides insight into split/shared visits. Otolaryngology prac... Read more
Risk Adjustment:
Understand How Risk Can Inform Visit Complexity
There's more to risk adjustment beyond reimbursement, experts say. If you want to impro... Read more
Reader Questions:
Understand Face-to-Face Visit Rules
Question: I read that when reporting discharge day management service, we must provi... Read more
You Be the Coder:
Can You Find This Modifier Mishap?
Question: Our otolaryngologist submitted an inpatient hospital visit code (99223) with mod... Read more
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