Otolaryngology Coding Alert
E/M Coding for Stopping Nosebleeds
Practice Manager, Louisiana
Answer: It boils down to whether you did a separate and significant E/M service while performing the procedure in your office. Carriers usually will not reimburse a separate E/M for essentially stopping a nosebleed (30901, 30903, 30905), unless it is for a new patient who arrives complaining of chronic nosebleeds. Some carriers may pay the E/M, but that does not mean it was correct. And if the coding is audited, the payment may have to be returned.
If the E/M was a separate and significant service, an office or other outpatient E/M code (99211-99215) should be billed with a -25 modifier attached, along with the codes for the procedure itself (30901, 30903 or 30905).
When appropriate, reimbursement is more likely if the E/M is accompanied by code 456.8 (varices of other sites; varicose veins of the nasal septum [with ulcer]), rather than 784.7 (epistaxis, hemorrhage from nose, nosebleed).
Otolaryngology Coding Alert
- Documentation Key to Maximizing Sinus Surgery Reimbursement
Getting reimbursed correctly for sinosurgery can be difficult. If, for example, an otolaryngologist performs endoscopic [...] - Reimbursement Tips for Allergy Injections and Supplies
Otolaryngologists frequently place patients suffering from allergies on injection programs. If the otolaryngologist gives the [...] - Payer Coommunication Key:
How to Determine When to Use Modifier -25 or -57
When an otolaryngologist performs a nasal endoscopy (31238) on a Medicare patient who comes in [...] - Reader Question:
Coding for New Technology
Question: In our office, we usually do direct laryngoscopy (31575) and a sinus scope (31231) [...] - Reader Question:
E/M Coding for Stopping Nosebleeds
Question: How should I code for cauterization of electrocoagulation and still get reimbursed for the [...] - Reader Question:
Coding for Snoring Treatment
Question: Has a new CPT code been established for somnoplasty procedures for snoring (i.e. procedures [...] - Reader Question:
PE Tube Removal
Question: How should we bill for the removal of bilateral PE tubes that were initially [...]
