Otolaryngology Coding Alert

Fortunately, the latest edition of CPT^® isn’t as earth-shattering as last year’s.

When the American Medical Association released CPT^® 2021 last fall, otolaryngology coders faced a steep learning curve as they worked to understand the massive changes to the outpatient E/M code set. Fortunately, the updates for 2022 aren’t anywhere near as comprehensive. Instead, you’ll just have to make a few adjustments so you can be up to date with the latest codes and descriptors.

Among the most relevant changes for ENT practices are a tweak to the descriptor for 99211 and revisions to the nasal fracture treatment codes. Read on to get some detailed knowledge on these respective changes so you can be prepared before the calendar turns to 2022.

Check This E/M Update

You’ll recall that CPT^® 2021 removed the time component from the 99211 descriptor, which previously said, “Typically, 5 minutes are spent performing or supervising these services.” For 2022, the AMA has further truncated the code descriptor, which now reads, “Office or other outpatient visit for the evaluation and management of an established patient, that may not require the presence of a physician or other qualified health care professional.” What’s missing is the previous verbiage stating, “usually, the presenting problem(s) are minimal.”

In the 2021 E/M guidelines, the AMA released its definition of “minimal,” noting that a minimal problem was one “that may not require the presence of the physician or other qualified health care professional, but the service is provided under the physician’s or other qualified health care professional’s supervision.”

Therefore, it’s possible that the AMA removed the “presenting problem(s) are minimal” terminology from the 99211 descriptor because it’s redundant, considering that 99211 is already meant to describe a service defined similarly to how the AMA defines a minimal problem.

Nasal Fracture Treatment Codes Shift

When it comes to the surgical codes, the 2022 updates are somewhat tame, other than a deleted code and two descriptor revisions affecting the nasal fracture treatment codes, as follows:

• 21310 (Closed treatment of nasal bone fracture without manipulation) has been deleted effective January 1, 2022.
• 21315 (Closed treatment of nasal bone fracture with manipulation; without stabilization) has been changed, with the new verbiage underlined.
• 21320 (Closed treatment of nasal bone fracture with manipulation; with stabilization) has been changed, with the new verbiage underlined.

ENT providers have previously indicated that the vast majority of their nasal bone fracture treatments involve manipulation (also referred to as “reduction”) to set the bone back into position, which could be why the AMA deleted the code describing closed treatment without manipulation. Effective January 1, if the otolaryngologist treats a nasal fracture without manipulation, you’d report the appropriate E/M code.

Stay tuned as the AMA releases more details about the new, revised, and deleted codes for 2022 — Otolaryngology Coding Alert will continue to report on the updates as more information is released.