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Otolaryngology Coding Alert

CPT® 2017:
Latest CPT® Edition Offers New Code for Injection Laryngoplasty
Changes could impact your reimbursement. The New Year is just around the corner, and w... Read more
Does Your PA's Modifier 25 Use Make the Grade?
Hint: Know your global periods. Your physician assistant is probably an integral part ... Read more
Evaluate Your ICD-10 Know-How With This Quick Quiz
These ENT-specific scenarios will help you gauge your knowledge. You’ve been rep... Read more
5 Quick 99211 Facts Help Guide Your Level 1 Coding
Hint: This code only applies to established patients. Code 99211 might be your go-to c... Read more
Patient Privacy:
Is Your Practice Texting in Line with HIPAA Standards?
Ensure that you’re protecting yourself and your patients when you text. Mobility... Read more
Reader Question:
Know When, How to Amend Notes
Question: Our office performed an audit prior to submitting our claim to insurance ... Read more
Reader Question:
Consider Type of Telemedicine When Choosing Code
Question: Often, one of our otolaryngologists or qualified nonphysician practitione... Read more
You Be the Coder:
Get the Right Code for Drainage of a Nasal Abscess
Question: A provider aspirates the excess fluid from an abscess within the nasal ca... Read more
Coding Eustachian Tube Testing Isn't Always a Precise Science
No code? No worries with this helpful advice. When a patient presents to your ENT offi... Read more
E/M Coding:
Can You Find the Problem With This E/M Chart?
Don’t make the same mistakes as this practice did—keep collecting for your E... Read more
Family Visits:
Discussing Patient's Care With Family? E/M Might Still Apply
As long as the patient is present, CMS allows you to bill an E/M code based on time. I... Read more
Reader Question:
Medicare Isn't the Only Auditor
Question: We treat pediatric patients who require otolaryngology care, so we don&rs... Read more
Reader Question:
Differentiate Laryngitis Types
Question: Which code should we report for laryngitis? Subscriber ... Read more
Reader Question:
Incidental Trach Is Not Billable
Question: We performed a tracheostomy during a laryngectomy and received a denial f... Read more
You Be the Coder:
Personalize Your Compliance Program
Question: Our practice bought a compliance plan from a consultant about eight years... Read more
Examine Your Coding Trends With a Benchmarking Study
Know exactly where your ENT practice stands by performing a code comparison. Have you ... Read more
Clip And Save:
Here's Your Breakdown of Which Codes Otolaryngologists Are Reporting Nationally
Once you compare your practice’s benchmarking data over time, you may want to take... Read more
ICD-10 Quiz:
Test Your Diagnosis Coding Skills With This Quick Quiz
From A codes to Z, we’ve got the ICD-10 answers you need to ensure quick claims pa... Read more
Reader Question:
Watch Your Modifiers for VNG Testing
Question: Can we bill independently under the audiologist for VNG testing done in t... Read more
Reader Question:
Let the Approach Guide Your 30117 vs. 30118 Choice
Question: Our surgeon performed wide local excision of a nasoseptal lesion, with un... Read more
Reader Question:
You Can Stop Looking for 'Admit' Code
Question: Our otolaryngologist admitted a patient to the hospital and asked the cod... Read more
Reader Question:
Know the 31295 Bundling Rules
Question: We performed an endoscopic lavage along with 31295 (Nasal/sinus endoscopy... Read more
You Be the Coder:
Verify Details Before Reporting a History of Cancer
Question: An established patient with a history of nasopharyngeal cancer was seen i... Read more
Medicare Payments:
CMS Signals Potential Changes to Modifier 25 With These ENT Services
The 2017 proposed Fee Schedule could make payment for E/Ms with select minor procedures ... Read more
WPS Medicare Identifies This Major Coding Problem Among ENTs
Hint: Don’t skimp on documentation. Most coding experts have heard the old adage... Read more
Get Your Documentation in Order Before Coding Obstructive Sleep Apnea
The 2017 proposed Fee Schedule could make payment for E/Ms with select minor procedures ... Read more
Reader Question:
Extent of Service Separates Tympanostomy from Myringotomy
Question: A patient came in for bilateral pressure equalization tube placement. The... Read more
Reader Question:
Meet These Criteria Before Reporting 31231 With 31575
Question: The otolaryngologist performed endoscopy in our office and reported 31231... Read more
Reader Question:
Submit 21499 for Styloidectomy
Question: The surgeon resected the patient’s right styloid process. What code... Read more
Reader Question:
Make Sure One System Is Marked for 'All Others Negative'
Question: Our otolaryngologist always marks “all others negative” in th... Read more
You Be the Coder:
Include Modifier 52 for 92550 on One Ear
Question: I have two questions about code 92550. Can we only use it when ipsilatera... Read more
Throat Procedures:
Here's How to Report Botox A to Treat Spasmodic Dysphonia
Tip: Pay special attention to reporting drug wastage. Spasmodic dysphonia (also known... Read more
Ear Focus:
Code Correctly for These 3 Common Ear Procedures
Start by digging into descriptors to better understand the service. Myringoplasty, tym... Read more
Associated Eye Symptoms Point You to the Correct Sicca Syndrome Code
‘Keratoconjunctivitis’ note will make the difference. Sicca syndrome (also... Read more
Reader Question:
Follow This Guide for Sequencing Sinus Surgeries
Question: I could use some help in correct coding and sequencing for sinus surgery.... Read more
Reader Question:
Using Endoscope Doesn't Change Septoplasty Code
Question: I am still new to the coding world and need to code for an endoscopic sep... Read more
Reader Question:
Stay Away From Considering 21025 for Bilateral Modifier
Question: One of our otolaryngologists wants to bill 21025 bilaterally with modifie... Read more
Reader Question:
Rely on the CCI Explanation for 60500 Bundling Into 60240
Question: Can you help me explain to my physician why CPT® 60500 bundles into 6... Read more
Reader Question:
MUE of '1' Means You Report 31535 Only Once
Question: My understanding of 31535 is that I code each time for a biopsy that was ... Read more
You Be the Coder:
Correctly Report Both Anterior and Posterior Packing
Question: My doctor states that he did both anterior and posterior packing for epis... Read more
October Will Bring Your First Official Updates to ICD-10
Look for expanded options for hearing loss, tinnitus, and more. Just as you’ve b... Read more
New Code Check-In:
Be Sure You Know How to Handle Drug-Eluting Stent Coding
  Start with a solid understanding of when they’re necessary. CPT® 20... Read more
Reader Question:
Code 92550 Covers Both Ipsilateral and Contralateral Reflexes
Question: Does code 92550 only apply when ipsilateral and contralateral reflexes ar... Read more
Reader Question:
Work of 60240 Includes Work of 60500
Question: Can someone help me explain to my physician why CPT® code 60500 bundl... Read more
Reader Question:
Learn the Ins and Outs of App Privacy
Question: Our clinicians are using more and more apps for a variety of reasons, inc... Read more
Reader Question:
Verify Approach Before Assigning Submandibular Drainage Code
Question: Our surgeon recently performed drainage of an abscess in the submandibula... Read more
Reader Question:
Submit 'Unlisted' 92700 for VEMP
Question: I am trying figure out the best CPT® codes to use for a Dix-Hallpike ... Read more
Reader Question:
The Work of 30905 Includes 30901
Question: My doctor states that he did both anterior and posterior packing for epis... Read more
Reader Question:
Keep Up With What OIG Is Watching
Question: I know that different reports come out periodically to show the issues or... Read more
Reader Question:
Let Work, Not Follow-Up Designation, Guide E/M Code Choice
Question:  Our physician recently saw a patient because of an abscess on her neck. ... Read more
You Be the Coder:
The Best Code for Lysis of Tonsil Adhesion
Question: A tonsillectomy patient now has a piece of skin adhered to the uvula. The... Read more
Procedure Focus:
Trying to Capture Trach Tube Changes With E/M Codes? Here's How.
Tip: Get clear documentation of the complaint. According to coding guidelines, 31502 (... Read more
Allergy Tests:
Check Your Answers to 3 Common Allergy Questions to Keep Claims on Track
Plus: Watch for opportunities to include E/M with the allergy care. Pollen coated surf... Read more
Dig Into the Options for Lymphadenopathy and Lymphadenitis
The terms are not interchangeable. If a patient sees your otolaryngologist because of ... Read more
Reader Question:
Encourage Providers to Document Laterality for More Accurate Dx
Question: Our provider diagnosed a patient with recurrent otitis media and chronic ... Read more
Reader Question:
Audiologist Must Have Her Own NPI for Billing Purposes
Question: How do I bill for an audiology service if the audiologist hasn’t ye... Read more
Reader Question:
Avoid Consultation Codes on Medicare Claims
Question: I have a denial for 99253 from Anthem Senior Advantage stating that this co... Read more
Reader Question:
Implanted Device Does Not Equal Foreign Body
Question: What is the correct ICD-10-CM code for a retained and malpositioned T-tub... Read more
Reader Question:
Think Anatomic Site, Then Addition, for Lesion Excision Coding
Question: I’m coding for two separate malignant lesions on the scalp. Do I ad... Read more
You Be the Coder:
File This for Flex Laryngoscopy With Meds
Question: I’ve not found any information about reimbursement for 31599. Consi... Read more
Coding Edits:
Newest CCI Pairs Bundle IV Infusions With Thousands of Procedures
But – The changes won’t alter your coding much. The latest version of Corr... Read more
Clip N Save:
Let This Chart Help You Keep Inferior Turbinate Codes Straight
Now it’s easy to know how to report each procedure.  ... Read more
Procedure Focus:
Remember 3 Checkpoints for Inferior Turbinate Procedures
Plus: Here’s how to handle middle turbinate coding. The nose has three turbinate... Read more
Stick With a Single Code for Unspecified Sensorineural Hearing Loss
The updated descriptor is basically the same. One diagnosis that hasn’t had much... Read more
Reader Question:
Choose 69220 for Cholesteatoma Debridement
Question: Our physician debrided a cholesteatoma in the external ear canal. How is ... Read more
Reader Question:
Study Options for Post-Tonsillectomy Hemorrhage Diagnosis
Question: I am having difficulty finding the appropriate ICD-10 code for post-tonsi... Read more
Reader Question:
Mine the Details Before Coding Co-Surgery
Question: I am receiving denials for code 62165 endoscopic pituitary tumor excision... Read more
Reader Question:
Laterality and Approach Determine PCS Code for 69436
Question: I can’t find the 2016 ICD-10 PCS code for 69436. Can you help? We... Read more
Reader Question:
Thorough Documentation Can Help Battle Endoscopy Denials
Question: Some of our physicians have been receiving denials for not documenting na... Read more
Reader Question:
'Diagnostic' Is the Key to Submitting Multiple Scopes
Question: The otolaryngologist performed a direct laryngoscopy, direct bronchoscopy... Read more
You Be the Coder:
Coding Grafts During Tympanoplasty
Question: I am confused on the graft codes during tympanoplasty. I know the graft i... Read more
Follow 3 Steps to Successful ENG Claims
Verify the correct number of codes to include. An otolaryngologist or audiologist will... Read more
Procedure Refresher:
Do You Know What Happens During ENG?
Understanding a procedure helps you code it better. An ENG is used to detect disorders... Read more
E/M Coding:
Test Yourself: How Would You Report This Multi-Visit Claim?
Remember that office visit coding isn’t always cut-and-dry. Pinpointing the corr... Read more
Are You Using All Your Options for Sialoadenitis Coding?
Don’t forget you have 4 diagnoses now. When the otolaryngologist diagnoses sial... Read more
E/M Coding:
Test Yourself: How Would You Report This Multi-Visit Claim?
Remember that office visit coding isn’t always cut-and-dry. Answer: In the scena... Read more
Reader Question:
Add Modifier 59 to Your 31295/31000 Claim
Question: Can you bill 31295 for maxillary sinus balloon dilation with 31000 for la... Read more
Reader Question:
Including Bilateral Modifiers With Nasal Endoscopy Codes
Question: Can the nasal endoscopy codes 31255, 31295, and 31297 be used with modifi... Read more
Reader Question:
Check Out H69.8~Family for Eustachian Tube Dysfunction
Question: Eustachian tube dysfunction had a specific code in ICD-9, but I haven&rsq... Read more
Reader Question:
No Payers Allow a Claim With 21325 and 30520
Question: We submitted a claim with codes 21325 and 30520. The insurer denied ... Read more
Reader Question:
Payer Could Be the Reason Behind 21012 Denial
Question: We’ve submitted two claims for 21012 performed in our office (for t... Read more
Reader Question:
Submit 42950 for Uvulopharyngoplasty
Question: Our otolaryngologist performed a lateral pharyngoplasty, then he excised ... Read more
You Be the Coder:
Verify the Dividing Line Between 21554 and 21556
Question: The otolaryngologist performed an open excision of a 3 cm tumor located i... Read more
Nosebleed Care:
Check the Technique Before Submitting 30901 for Repair
Plus: Don’t forget you have different codes for posterior bleeds. A patient come... Read more
E/M Coding:
Follow 4 Solid Tips to Overcome Observation Obstacles
Watch the dates to hone in on the correct code. Physicians often admit patients to a h... Read more
Choose Between Two Codes for Unspecified Benign Neoplasm of Mouth
Pay attention to ‘other’ versus ‘unspecified’ distinction. If ... Read more
Reader Question:
Only Submit 64490 With 69436 When Medically Necessary
Question: My patient’s tube went into the middle ear. The physician took her ... Read more
Reader Question:
Check for Green Light With Multiple Endoscopy Codes
Question: Can codes 31255, 31295, and 31297 be used with modifier 50? Can they be r... Read more
Reader Question:
Don't Assume All Facial Lymph Node Excisions Are Superficial
Question: Our physician wants to bill 38500 for a deep lymph node excision of the c... Read more
Reader Question:
Choose Two Codes for Different Hearing Loss in Each Ear
Question: ICD-9 code 389.16 crosses over to H90.5 in ICD-10, but my physician says ... Read more
Reader Question:
Include a Modifier to Report 69801 With 99213
Question: Is it possible to bill an office visit code such as 99213 with a steroid ... Read more
You Be the Coder:
Look Here for Eustachian Tube Obstruction
Question: Eustachian tube dysfunction had a specific code in ICD-9 (381.81), but in... Read more
CCI 22.0:
Update Your Systems to Reflect the Latest Coding Edits
Pay special attention to cerumen removal services. With more than 57,000 Correct Codin... Read more
Teaching Patients About Asthma Could Count as Prolonged Service
Here’s your guide to E/M documentation success. Wintertime can be difficult for ... Read more
E/M Coding:
Refresh Your Knowledge of Codes 99415 and 99416
Don’t forget these other prolonged service options. As you adjust to the newest ... Read more
Don't Cross Codes for Acute and Chronic Tracheitis
You still have only one code for acute patients. Acute tracheitis is one condition yo... Read more
Reader Question:
Don't Fall in the 'Same Group Physicians/Separate E/M' Trap
Question: Two otolaryngologists in our practice treated a patient twice on the same... Read more
Reader Question:
Get Physician Perspective on the Best LPR Diagnosis Code
Question: What is the best diagnosis code for laryngopharyngeal reflux (LPR)? Ala... Read more
Reader Question:
Be Wary of Thyroidectomy/Parathyroidectomy Edit Bundles
Question: I know that the parathyroidectomy and thyroidectomy are incidental to eac... Read more
Reader Question:
Submit 'Unclassified' for Restylane
Question: Can you help me with the correct code to use for Restylane billing? I nee... Read more
Reader Question:
Include Modifier 59 for Multiple FNAs to Different Sites
Question: What is the proper way to code 10021 for a fine needle aspiration on the ... Read more
You Be the Coder:
Remember the Difference Between Chronic Rhinosinusitis and Chronic Sinusitis
Question: One of our payers has a new FESS (Functional Endoscopic Sinus Surgery) po... Read more
Office Procedures:
Keep 3 Points In Mind Before Coding Scopes With E/M
Hint: Get all your documentation straight first. Although your otolaryngologist knows ... Read more
2016 CPT® Updates:
Remember to Add New Endoscopic Codes to Your Mix in 2016
Check whether you can report these sinus implants. CPT® already includes a fair nu... Read more
Brush Up on When 62 Fits for Co-Surgery
Be sure to match both surgeons’ codes. Otolaryngologists sometimes perform surge... Read more
Add 'Unspecified' to Your Acute Pharyngitis Descriptor
One word is the only difference between old and new. When you still reported diagnoses... Read more
Reader Question:
Dig for Injury Date if Scrubber Requires It
Question: Our claim scrubber is kicking out claims for removing foreign bodies from ears... Read more
Reader Question:
Photographs Aren't Needed to Support Stroboscopy
Question: What type of documentation is required for physician to be reimbursed for perf... Read more
Reader Question:
Submit 30801 With 31240 and Clear Documentation
Question: I am trying to understand the reasoning behind bundling 30801 with 31240. My s... Read more
Reader Question:
Let Anesthesia Guide Tympanostomy Code Choice
Question: My physician placed a ventilation tube in an eardrum but did not perform a myr... Read more
Reader Question:
Verify With Workers' Comp Before Using ICD-10
Question: I’ve heard that we shouldn’t use ICD-10 for workers’ compens... Read more
You Be the Coder:
Check This When Deciding Between CPAP or E/M
Question: A patient underwent a sleep study and came to our office afterwards for an eva... Read more