Wiki ENT Coding Assistance Please

[dmcgraw]

Good morning:

I need assistance with ICD9 code for Blom Singer prosthesis - my docs insist that they can bill in addition to an E/M, however, I have not been able to find a suitable code, except possibly 31899 with notes attached. I would also like to inquire if your docs attempt to bill trach change separate from their E/M? Thank you so very much for your assistance

 

[jackjones62]

If you are asking if your MD can bill for the changing of a Blom Singer Voice prosthesis in the office, the answer is "no"; most MD's bill the appropriate level of E/M, base it on the time required to change it and any E/M performed that day; if it requires the use of a scope, bill the scope; make sure the MD documents that time involved; with regards to your trach change statement, per coding guidelines, you should only bill for trach changes performed before the new tracheostomy has healed and formed a fistual tract; the guidelines suggest that trach changes are usually done within a few days of the original trach, but that is subject to interpretation, a gray area, if you will, I usually use a 30 day guideline; if a tracheostomy was performed several months or even years ago and a patient comes to the office for a trach change, bill an E/M only; if a scope was used, bill that as well, just do not bill the trach change, not appropriate.

Hope this helps, you might want to post your ENT questions under Otolaryngology instead for better exposure.

Jennifer
CT ENT

 

[liz_snyder]

What is the trach change was done several months later but in the operating room not the office setting?

 

[suec]

Did you get a response to your question?