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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
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
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
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
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
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
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
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
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
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
Considering Waiving Copays? Check These Tips First
Proving financial hardship will be the key to confirming eligibility.In seminar after semi... Read more
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
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
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
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
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
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
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 Date Will Be Postponed, HHS Confirms
Delay could offer practices additional time to prepare for new diagnosis coding system.Jus... Read more
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
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
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
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
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