Otolaryngology Coding Alert

Question: I performed bilateral myringotomy with tubes (10 global days) and an adenoidectomy (90 global days). I saw the patient for apostoperative visit and audiogram three weeks later. How should I code the
visit and audiogram?

New York Subscriber

Answer: You should bill only the audiogram. When reporting procedures during a global surgical period, claim only unrelated services.
     
In your scenario, the adenoidectomy (42830-42836, such as 42830, Adenoidectomy, primary; under age 12) triggered the global period. The E/M presumably relates to the adenoids and the tubes. So you shouldnt bill an

E/M code for the service. To track your follow-up work, instead report nonpaying code 99024 (Postoperative follow-up visit, normally included in the surgical package, to indicate that an evaluation and management service was performed during a postoperative period for a reason[s] related to the original procedure).
     
Because the audiogram relates to the tympanostomy (69433, Tympanostomy [requiring insertion of ventilating tube], local or topical anesthesia; or 69436, Tympanostomy [requiring insertion of ventilating tube], general anesthesia) whose postoperative period expired, you should report the69433-69436-related service with the appropriate audiogram code (such as 92557, Comprehensive audiometry threshold evaluation and speech recognition [92553 and 92556 combined]).
     
Remember you dont need to append a modifier to the audiogram code. It doesnt relate to the existing postoperative period.