Otolaryngology Coding Alert
Extra Cleaning Earns Intermediate Repair
Question: Our ENT removed extensive debris from a wound that then required a single-layer closure. Should I report this service with a code for wound repair or a code for foreign-body removal?
Ohio Subscriber
Answer: Because the doctor performs extensive removal of particulate debris, you should report an intermediate code for the repair, such as 12051 (Layer closure of wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 2.5 cm or less).
Tip: CPT states that -single-layer closure of heavily contaminated wounds that have required extensive cleaning or removal of particulate matter also constitutes intermediate repair.- Payers following CPT rules recognize the extra work of the extensive cleaning and removal through more intensive and higher-valued intermediate repair codes.
Otolaryngology Coding Alert
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If you're treating Medicare and private payers the same, you're losing payments
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Question: The ENT meets with a patient and recommends a nasopharyngoscopy, which the patient schedules [...] - READER QUESTIONS:
31505 Isn't Separate From E/M
Question: Can we report a mirror exam using 31505 in addition to a same-day E/M [...] - READER QUESTIONS:
Stick With 99218-99220 for 8 Hours or Less
Question: We have a long-standing argument in our office regarding the proper use of observation [...] - READER QUESTIONS:
Extra Cleaning Earns Intermediate Repair
Question: Our ENT removed extensive debris from a wound that then required a single-layer closure. [...] - READER QUESTIONS:
'3-Year Rule' Applies to Practice, Not Physician
Question: A patient sees an ENT in our group practice. More than two years later, [...] - READER QUESTIONS:
Strike 90788 From Your Code Choices
Question: We-ve received notice from our payers that 90788 is invalid after Dec. 31, 2005. [...] - READER QUESTIONS:
The Right Times for You to Report 94060 and 94640
Question: My ENT sometimes performs pre- and post-treatment pulmonary function tests (PFTs). How should we [...]
