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Otolaryngology Coding Alert

Case Study:
Breathe Easy When It Comes to Turning Nasal Notes Into a Flawless Claim
Give your sinus and turbinate coding skills a test. When approaching any claim, the tr... Read more
Allergy Coding:
6 Steps Turn Your EAA Workup From a Headache to a Coding Breeze
Hint: 94010, 94375 are shoe-ins for bundled status. A workup for possible extrinsic al... Read more
Fee Schedule:
Finalized 2013 Fee Schedule Includes 26.5 Percent Cut
Plus: Transition care management pay is formalized with assignment of codes 99495-99496.... Read more
ICD-10:
Your 'Mono' Code Will Have More than One Option in 2014
Don't forget to make this fifth digit selection. When ICD-10 goes into effect, you'll n... Read more
Reader Question:
Any Doctor Can Use ED Codes
Question: An emergency department (ED) physician asked our ENT to see a patient who has ... Read more
Reader Question:
Extra Step Changes 21315 to 21320
Question: When choosing between 21315 and 21320, what are acceptable forms of stabilizat... Read more
You Be the Coder:
Use 2 Codes When ENT Occludes Canal
Question: What CPT code should I use for "posterior semicircular canal ablation," which ... Read more
Throat:
3 Steps Steer Your Tonsil/Adenoid Removal Claims Toward Success
Secret: You can use 42820, 42821 as universal T&A codes.Warning: You must know a patie... Read more
Modifiers:
How to Ensure Modifier 25 Appeals Are Worth Your Time
4 tips show you what to do when you get that E/M denial. The next time you don't ... Read more
Audiology:
Reporting Hearing Aid Supplies With 99070? Read This First
V codes are your key to more options and better specificity, experts sayJust because ... Read more
ICD-10:
Change to R04.0 for Epistaxis Under ICD-10
Plus: Remember right/left modifiers according to payer policy.Under ICD-9 rules, you have ... Read more
Reader Question:
Use Modifiers to Identify Each FBR
Question: An otolaryngologist removes a bead from each of a child's ears under anesthesia.... Read more
Reader Question:
Consider Cholesteatoma Removal Incidental
Question: Under general anesthesia, an otolaryngologist explores a chronic otitis media pa... Read more
Reader Question:
Multiple Nasal Procedures Require Medical Necessity
Question: My otolaryngologist performs a nasal vestibular stenosis repair (30465) as well ... Read more
You Be the Coder:
'Plasty,' Not Condition, Determines 69140 Versus 69310
Question: An otolaryngologist performs a canalplasty with osteoma excision. Should I rep... Read more
CPT® 2013:
Start Learning These Allergy Changes and Subtle E/M Revisions Now
New CPT® manual will feature 186 new codes and 119 deletions, AMA reveals.Although t... Read more
Post-Op Infections:
2 Tips Perfect Your Post-Op Infection Claims
Check out these three examples to test what you've learned.If you include postsurgical inf... Read more
Coding Quiz:
Evaluate Your E/M Coding Skills With 3 Questions
Test your skills with these questions to see where you should focus your E/M education.Eva... Read more
ICD-10:
CMS Confirms Oct. 1, 2014 As New ICD-10 Implementation Date
One year delay is expected to allow practices more time to prepare.It's been nearly eight ... Read more
Coding Quiz Answers:
Evaluate Your E/M Coding Skills With 3 Answers
Check your coding against these answers to see where you should focus your E/M education.A... Read more
Reader Question:
Don't Separate Microscope During Follow-up
Question: An otolaryngologist in our group practice wants to report 92504 every time he lo... Read more
You Be the Coder:
Learn What 'Secondary' Means For Adenoidectomies
Question: When reporting adenoidectomy with tonsillectomy, does it matter if the adenoidec... Read more
Case Study:
Troubleshoot Your Tube Removals By Examining 3 Examples
You can only report 92504 in this circumstance.You know you should include tube removals a... Read more
Modifiers:
Avoid Modifier 25 Mishaps With This Expert Advice
Tip: All procedures include an inherent E/M component.Every time you fail to report a legi... Read more
EMGs:
Go In-Depth With these Botox Tips for Vocal Cord Injection Claims
Make certain the documentation supports medical necessity. Times are tough, and you should... Read more
ICD-10:
Don't Hold Your Breath For ICD-11 as an ICD-10 Alternative
Here's why CMS will ignore the AMA's endorsement.The American Medical Association (AMA) ha... Read more
Reader Question:
'Supple' May Refer to These Systems
Question: When my otolaryngologist writes "Neck is supple," should I count the phrase as p... Read more
Reader Question:
Look for a '1' Indicator to Unbundle 31255, 31254
Question: When can I unbundle CCI edits?Georgia SubscriberAnswer: Each Correct Coding Init... Read more
You Be the Coder:
Which Codes Apply to Bronchitis?
Question: When I use 491.9 to describe a patient's bronchitis, payers often deny the code ... Read more
Allergy Coding:
Go Back to Basics With Nebulizer-Services Coding
These 3 case studies will illuminate key coding concepts. If your allergist treats res... Read more
Ear Coding:
6 Guidelines Point You to the Correct Complicated Ear Diagnoses
Report otomycosis underlying disease, ICD-9 instructions indicate. When chart notes co... Read more
Billing:
Considering Waiving Copays? Check These Tips First
Proving financial hardship will be the key to confirming eligibility.In seminar after semi... Read more
ICD-10:
Acute Laryngitis Remains Easy Coding With J04.0 in ICD-10
Look how many conditions the code will represent when ICD-10 goes into effect.Diagnosis co... Read more
Reader Question:
Don't Let Bee Stings Complicate Your E/M Coding
Question: A patient with complications from a bee sting presented to our office. Our aller... Read more
Reader Question:
Look to Modification When Choosing Lymph Removal Code
Question: My otolaryngologist performs a selective neck dissection of levels 1-3. How shou... Read more
You Be the Coder:
Don't Report 31575 With 31579
Question: May I bill a laryngoscopy and a videostroboscopy for a patient complaining of ho... Read more
FNA versus PNB:
Confused by Terms "Aspiration" Versus "Biopsy?" Uncover These Clues
Not all sample specimen retrievals are the same. You may know that CPT® contains spe... Read more
E/M Coding:
Quick Answers to Your Top 3 Hospital E/M Billing Queries
Find out how many minimum hours Medicare requires a patient to be in observation care.Are ... Read more
ICD-10:
Opinions Vary as to ICD-10 Delay Advantages
Did you know? The AMA has requested a further delay.Whether you submitted comments to CMS ... Read more
Reader Question:
Reserve Modifier 55 for Post-Op Package
Question: Would you please explain when we should use modifier 55? I am not clear on what ... Read more
Reader Question:
Where Sleep Study Performed Determines POS
Question: Our otolaryngologists are certified to interpret sleep study results (95807-9581... Read more
You Be the Coder:
Include Mirror Exam in E/M Code
Question: When an otolaryngologist performs a same-day office visit and mirror exam, shoul... Read more
Ear Coding:
Avoid These Pitfalls to Maximize Your Ear Tube Removal Claims
Tip: Tympanic repair will call for separate procedure coding. Although you'll gen... Read more
Scopes:
Focus On Anatomy When Deciding Between 31575 and 92511
Choosing the correct code can make a difference of $28. When you're attempting to ... Read more
News You Can Use:
OIG to Send CMS Names of 1,700 Docs Who Overbilled High-Level E/M Codes
Frequency of reporting 99214 and 99215 increased 17 percent over 9-year period.If you exam... Read more
ICD-10:
Find Out How ICD-10-CM Will Impact "Impacted Cerumen" Code 380.4
Remember to choose the code with the highest specificity.Currently, you have one way to re... Read more
Reader Question:
CCI 18.1 Edits Affect Auditory Function, Speech Testing
Question: I noticed that the Correct Coding Initiative edits version 18.1 came out and wen... Read more
Reader Question:
Combine Physician Work for Same-Day Visit
Question: If two allergists in the same group see the same office patient on the same day,... Read more
You Be the Coder:
You Need to Know Approach for CSF Repair Code
Question: An otolaryngologist and neurosurgeon are doing a surgery together. The patient h... Read more
Coding from the Op Note:
Are You Reporting Custom Tracheal Resections? Follow This 5 Step Approach
Your best strategy may be applying these modifiers. Otolaryngology coding can hold surpris... Read more
Modifiers:
Avoid Jeopardizing Your E/M Pay By Reviewing These Modifier 57 Rules
Watch out: Some payers may direct you to use this modifier instead.In these tough economic... Read more
News You Can Use:
You Can Stop Worrying About a 27 Percent Medicare Cut -- Until the End of the Year At Least
This delay will only push payment formula problems to 2013.If your otolaryngology practice... Read more
ICD-10:
CMS Proposes One-Year Delay for ICD-10
Don't count on the delay quite yet, coding expert warns.No doubt you have been wondering h... Read more
Reader Question:
Avoid Appeals 'Form Letters' If You're Hoping for Success
Question: After checking to be sure we haven't made a coding or billing entry error, our p... Read more
Reader Question:
No History? Don't Assume Comprehensive Level
Question: Our physician admitted someone as an initial inpatient, but couldn't get all her... Read more
You Be the Coder:
Radical Resection of Malignant Ear Melanoma with FTSG
Question: How should I code a radical resection of malignant ear melanoma with full-thickn... Read more
Coding from the Op Note:
Add $368 in Ethical Reimbursement to Your Cyst Excision Claims
Mixing up branchial and preauricular cysts can put you in the wrong CPT section. Unless yo... Read more
Coding Rules:
Code Preauricular Cyst Excision Using 3 Closure Rules
You'll sometimes use one skin code -- and other times two. Since no site-spec... Read more
Billing Primer:
Considering Going Out of Network? Follow These 3 Tips to Pave the Road to Success
Be honest with your patients to ensure a smooth transition.More and more providers are que... Read more
ICD-10:
Draw the Line From 474.12 to J35.2
Tip: Use this diagnosis when ENT documents "enlargement of adenoids." Patien... Read more
Reader Question:
Is Graft Inherent in Myringoplasty?
Question: An otolaryngologist performed myringoplasty (69620) and harvested a graft. Can... Read more
Reader Question:
Fight For Your 61782 Payment
Question: I submitted a claim for 31267 and 61782 using the same diagnosis. The insurance ... Read more
Reader Question:
Straighten Out Functions of Specific Sinusectomy Codes
Question: When should I report sinusectomy codes? When a surgeon suctions purulent mucoid ... Read more
You Be the Coder:
Modifier 52 Requires Base Surgery
Question: I understood that 69450 (tympanolysis) is for time spent cleaning out a patien... Read more
Throat Coding:
Bust 4 Myths to Breathe Easy When Submitting Tracheotomy Claims
Beware separate-procedure status of planned tracheostomy. If you're making assump... Read more
Clip 'n' Save:
Confused by Sinus Anatomy? This Diagram Highlights Billable Landmarks
Find out what diagnoses go with what FESS procedures.Warning: If you can't keep track of w... Read more
ICD-10:
ICD-10 Date Will Be Postponed, HHS Confirms
Delay could offer practices additional time to prepare for new diagnosis coding system.Jus... Read more
Modifiers:
Do You Pick the Correct E/M Modifier Every Time? Find Out.
Hint: Assign 57, not 25, for E/M prior to major surgical procedure. Your surgeon perfo... Read more
Modifier 25:
Conditions for Use
When appending modifier 25, the E/M service must meet these requirements:The E/M is signif... Read more
Modifier 57:
Conditions for Use
To append modifier 57 properly, you must remember these points: The E/M service occ... Read more
Modifier 24:
Conditions for Use
When you report modifier 24, the E/M service must meet these criteria: The E/M serv... Read more
Reader Question:
Here's When To Treat Established Patients As New
Question: We saw a patient over a year ago for a thyroidectomy, and now the patient return... Read more
You Be the Coder:
Payment for E/M + 69210 Is Possible, If You Meet Reqs
Question: When we bill an impacted cerumen removal (69210) with an office visit (99201-992... Read more
CCI 18.0:
Learning These Parathyroidectomy and Wound Edits Is As Easy As 1, 2, 3
Remember: If a Category III code exists, then you should forgo an unlisted code. You may j... Read more
Scopes:
Explore Your Diagnostic Scope Coding Options to Ensure Maximum Pay
Tip: Make this 'rigid' versus 'flexible' scope distinction. Are you relying on 31575 f... Read more
ICD-10:
Your 'Other Anomalies' Code 748.3 Expands to More Specific 'Other' Codes
Tip: Beware submitting probable diagnoses. If you use 748.3 for all your 'other' congenita... Read more
Reader Question:
Is 69205-50 Appropriate?
Question: An otolaryngologist removes a foreign body from both ears under anesthesia. Shou... Read more
Reader Question:
Find Out Who Can Perform History Element
Question: My coworker thinks an allergist must take a patient's history, but I think a nur... Read more
Reader Question:
Use Modifiers In This Turb-Post-Op OV Scenario
Question: A patient who is returning for follow-up after unilateral endoscopic maxillary a... Read more
You Be the Coder:
Endoscopic Nosebleed Control
Question: A patient came into our office with a nosebleed. My otolaryngologist provided ... Read more
Thyroid Coding:
Find Out When to Report Dissections Separate From Thyroidectomy
Heads up: "Functional," "selective," and "radical" refer to the same procedure. Thinking y... Read more
OIG Report:
Pay Attention to E/M Levels, G Modifiers, and More, OIG Warns
Check your compliance on the areas in the 2012 Work Plan before OIG does.Every practice kn... Read more
ICD-10:
Uncomplicate Your Mumps Diagnosis by Shifting to B26.9 in 2013
Cheer for this 1-to-1 correlation. Mumps is a virus common in children that can lead to fe... Read more
Correction
In the article, "CPT® 2012: Is Your Audiologist Performing OAE Testing? Check Out Ne... Read more
Reader Question:
Avoid 99211 With 96372 at All Costs
Question: If a patient pays for her medicine and goes to our nurse to give the injection, ... Read more
Reader Question:
Find Out if You Can Submit 31238 and 31231 Together
Question: Can I report 31238 and 31231 together and be paid for both?California Subsc... Read more
Reader Question:
Check CMS For Bilateral Status Indicator
Question: Can I bill 69801 bilaterally?Florida SubscriberAnswer: Yes. Code 69801 (Labyrint... Read more
Reader Question:
No Exact ICD-9 Code? Refer to Closest Diagnosis Equivalent
Question: My otolaryngologist saw a patient for "ciliary dyskinesia." This condition occur... Read more
Reader Question:
Count 'No Fever' in ROS
Question: I have found information and heard at seminars conflicting information regarding... Read more
Reader Question:
Tackle This Tonsillectomy and Adenoidectomy Scenario
Question: An otolaryngologist performs a tonsillectomy and secondary adenoidectomy. May I ... Read more
You Be the Coder:
31295, 31256: Different Sides Warrant Modifier 59
Question: My ENT doctor did bilateral frontal sinuplasty and nothing else on the frontal s... Read more