Otolaryngology Coding Alert

Question: We have recently been advised Tricare/Champus will pay for custom-made swim plugs/noise plugs. The only code I can find to bill for this service is 99070, and it is a non-specific supply code. Is there a better code to use?

Mississippi Subscriber

Answer: Using 99070 (supplies and materials [except spectacles], provided by the physician over and above those usually included with the office visit or other services rendered [list drugs, trays, supplies, or materials provided]) with a copy of your invoice will get the claim paid. This is a universal code that insurers use to identify supply items. Without a description of the item, supplies often get denied using this code.

The HCPCS Level II Coding Manual is a good reference book that contains codes for non-physician procedures such as ambulance services, durable medical equipment and specific supplies. These codes supplement CPT. Level II codes consist of one alpha character followed by four digits. It is always wise to look for the description of your supply item here first. If the HCPCS book does not contain a code that fits, then you should send an invoice of your bill to the carrier for the custom-made swim plugs/noise plugs that shows how much they cost, says Linda Jackson, CCS-CPC, a Medicare consultant for Iowa Veterans Home in Marshalltown, Iowa.