Otolaryngology Coding Alert
69540 Requires Tube Removal
Question: How should I code for tympanostomy tube and aural polyp removal under general anesthesia? The otolaryngologist performed both procedures during the same operative session. Answer: You should bill only the aural polyp excision (69540, Excision aural polyp). The National Correct Coding Initiative (NCCI) 10.3 bundles the tube removal (69424, Ventilating tube removal requiring general anesthesia) into the excision code. Because the physician has to remove the tube to enter the middle ear, the edits make sense.
Montana Subscriber
You could, however, report separate side polyp and tube removal. For instance, if an otolaryngologist performs bilateral tube removal and excises an aural polyp from a patient's left ear, you should report:
Modifier -59 (Distinct procedural service) informs the payer that the tube removal occurred on a separate site from the excision. The body-side modifiers (-LT, Left side; -RT, Right side) help explain the different sides.
Otolaryngology Coding Alert
- These Clues Help You Distinguish Between Aspiration and Biopsy
Key: Bill FNA for fluid/cell sampling and PNB for tissue collection If you report an [...] - You Be the Coder:
How to Report Routine Postsurgical Observation
Question: Our otolaryngologist performs tonsillectomies and adenoidectomies (T&As) as an outpatient service. After the surgery, [...] - 1 Easy Way to Keep FNA and PNB Straight
Determine aspiration or biopsy with a glance at this chart
Seven clues can help you zoom [...] - How to Ensure Modifier -25 Appeals Are Worth Your Time
HIPAA, CPT guidelines may convince insurer to pay up The next time you don't know [...] - News Brief:
2005 Fee Schedule Delivers Mixed Bag to ENTs
Although otolaryngologists will benefit from Medicare's slight rate hike in 2005, your total payment could [...] - Reader Questions:
2 Codes Describe Airway Obstruction
Question: Could you please help me with an ICD-9 code for concha bullosa? I have [...] - Reader Questions:
69540 Requires Tube Removal
Question: How should I code for tympanostomy tube and aural polyp removal under general anesthesia? [...] - Reader Questions:
Include In-Office Collection Work in E/M
Question: When an otolaryngologist tests a patient for respiratory syncytial virus (RSV) in the office, [...] - Reader Questions:
Bill Medication, Not Supply With Pulmonary Codes
Question: May an otolaryngologist's office bill methacholine in addition to the bronchospasm test? Also, may [...] - Reader Questions:
Extra Step Changes 21315 to 21320
Question: When choosing between 21315 and 21320, what are acceptable forms of stabilization?
Maine Subscriber
Answer: [...] - Reader Questions:
NCCI Isn't Only Correct Coding Guide
Question: An otolaryngologist reported 12042 and 38542. Is that an appropriate combination?
Florida Subscriber
Answer: Even [...]
