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Otolaryngology Coding Alert

Read These Fast Facts on Air Irrigation's Streamlined Reporting Rules
Great news: This vestibular test now falls under a specific code Be sure you take advanta... Read more
Get the Inside Scoop on Balloon Sinuplasty Coding
Be careful: Regular sinus codes don't capture the new technology's work, AAO-HNS warns&nbs... Read more
5 Things to Consider When Reviewing Billed Service Levels
Teach otolaryngologists to write iron-clad MDM notes You can't get inside your ENT's head... Read more
READER QUESTION ~ Expect CPT 2007 to Revise Mohs/Consult Codes
Question: I heard that CPT 2007 is going to change the Mohs codes. How will that affect ou... Read more
READER QUESTION ~ Include Debridement in Complex Ear Repair
Question: We saw a patient at the hospital who was in a motor vehicle accident (MVA). Our ... Read more
READER QUESTION ~ Avoid Reporting Oxygen Administration
Question: When an office patient requires oxygen, which CPT code should I use for administ... Read more
READER QUESTION ~ Take Payer's Cue on Modifier for 31254, 31255 Claim
Question: Could an otolaryngologist perform 31254 and 31255 at the same session? Is it pos... Read more
READER QUESTION ~ Apply Medicare Guideline to Bilateral Repair
Question: An otolaryngologist removes tubes (69424-50, Ventilating tube removal requiring ... Read more
READER QUESTION ~ Incorporate 6 Changes to 389 Subcategory
Question: Is there a new way to code asymmetrical hearing loss?Louisiana SubscriberAnswer:... Read more
YOU BE THE CODER ~ Patient-Initiated Request
Question: A patient with a long history of chronic rhinosinusitis presents for a second op... Read more
Recoup $35 for CRP by Filing 92700:
Most Of the Time
These 5 secrets will help you obtain Epley maneuver pay If you-re having trouble receivin... Read more
Educate Insurer to Prevent Denials of Epley Maneuver
This ready-to-go form reduces your filing work A good form letter that includes the Eple... Read more
2 Scenarios Show When Consult Confirmation Is Proper Protocol
Time-saver: You don't always need fax request proof Before you complete another fax reque... Read more
Get the Answers to Your Top Audiology Questions
CPT is very clear about what qualifies for 92543 Does Medicare Allow In-House Audio Refer... Read more
Reader Question:
Look to 30220 for Septal Button Insertion
Question: Our surgeon inserted a septal button to treat a septal perforation. Which code s... Read more
Reader Question:
Let Day Steer 31238 Modifier
Question: Yesterday a patient had 30520 and 30140-50. Later that day, the patient returned... Read more
Reader Question:
Scrutinize Endoscopic Vs. Open Surgery
Question: Our surgeon documented the following biopsy: -I passed an endoscope into the rig... Read more
Reader Question:
PO Epistaxis Control Can Be Billable
Question: Dr. A performs 30140 and 30150. Ten days later the patient returns to the office... Read more
Reader Question:
Should You Bill Post-69436 Tube Replacement?
Question: A non-Medicare patient was seen on Aug. 11, 2006, for a mastoidectomy and a tymp... Read more
You Be the Coder:
What Does 31233 Represent?
Question: After performing a sinus surgery, an otolaryngologist examines the inside of eac... Read more
Get a Grip on Tongue Cancer Terminology
You can pin down the right neoplasm ICD-9 code with a few quick tipsDo you know your ventr... Read more
Match the Anatomic Tongue Site to the Proper Neoplasm Code
Select the correct ICD-9 code every time with this simple toolIf you have trouble picturin... Read more
Connect the Neoplasm Table To the Right Diagnoses
Learn the differences between primary, secondary and in situYou-ve used our article and ch... Read more
5 Quick Tips Help You Collect For Cerumen Removal
Watch your ICD-9 codes if the physician performs E/M with removal Payers may seem not... Read more
READER QUESTIONS:
You Can Bill Global Fee for CT Scan
Question: We recently bought a mini CT scan device and have started performing CT scans of... Read more
READER QUESTIONS:
Use E/M Codes for Patient-Generated Second Opinions
Question: I know that CPT deleted the confirmatory consult codes for billing second opinio... Read more
YOU BE THE CODER:
Can You Collect for Both 31231 and 30140?
Question: Our surgeon performed a diagnostic endoscopy (31231) and a submucous turbinate r... Read more
Learn the Must-Know Principles of Turbinate Surgery Coding
Do you know an excision from a reduction? Your reimbursement depends on it Considering th... Read more
Turbinate Surgery Decision Matrix
                Select the correct proce... Read more
Coding Quiz:
Determine Your NPP Coding Know-How
Can a nonphysician request consults? The answer may surprise you You might think you-ve g... Read more
Clarification:
You Can Report Consult if ENT Later Assumes Care
In the April Otolaryngology Coding Alert, the article -Your Consult Documentation Needs Im... Read more
Reader Questions:
Base Modifier 51 Necessity on Payer
Question: Do we need to append modifier 51 to our surgical claims on subsequent lines of s... Read more
Reader Questions:
Don't Count on Botox Payment for Dysphagia
Question: Our otolaryngologist performed a botox injection in the hospital to treat a pati... Read more
Reader Questions:
Consider 31238 for Post-Op Hemorrhage
Question: Our surgeon treated a post-op hemorrhage for bleeding in the ethmoid cavity foll... Read more
Reader Questions:
Carriers' Bilateral Rules May Differ for ASCs
Question: I read your ASC coding article last month with great interest and I have a follo... Read more
Reader Questions:
Include Prescription Writing in E/M
Question: I recently attended a seminar in which the presenter said we can bill a particul... Read more
You Be the Coder:
Are Separate Notes Needed for E/M, Procedure?
Question: In our office, we usually use one note to describe a procedure and an E/M. Why d... Read more
Follow the Scope to Differentiate Between 92511 and 31575
Reviewed on May 21, 2015 Key differences help you decide whether surgeon performed n... Read more
Let This Chart Help You Pinpoint Accurate Endoscopy Codes
Match the site to the documentation and you-ll choose the right code every time If you do... Read more
Operative Report Examination:
Take 5 Steps When Coding Complex Turbinate Excision
Determine whether the procedure was -unusual- before you append 22 When you-re coding a ... Read more
Answers to These 4 FAQs Can Help ASC Coders Collect
Get to know modifier SG when you bill for an ASC Any otolaryngology coder who has suddenl... Read more
Reader Questions:
Insurers Will Bundle Old Tube Removal
Question: Our ENT documented the following note: -An impacted foreign body (FB) that appea... Read more
Reader Questions:
Spot the Difference Between 30560 and 31237
Question: Can we report lysis of synechia separately from other procedures? Our otolaryngo... Read more
Reader Questions:
Avoid 99070 With Tube Code in the Office
Question: Our surgeon performed a tube insertion on a patient in the office, and I thought... Read more
You Be the Coder:
Can We Bill an E/M Code for Discussion?
Question: If the otolaryngologist sees a patient postoperatively for one hour to discuss t... Read more
ICD-9 Update:
Enhance Your Hearing Exam, Pain Claims With These New Diagnosis Codes
Increase specificity starting this October with the debut of several codes.If you-ve been ... Read more
Operative Report Examination:
Use Modifiers to Ease the Pain Of Custom Tracheal Resections
Follow a 5-step approach to find the right codesOtolaryngology coding can hold surprises. ... Read more
Reporting J7616, J7617? HCPCS 2006 Requires You to Change Your Coding
Tip:  Learn how you should use modifiers KP, KQIf you-re still reporting inhaled albu... Read more
Discover When You Can Report Same-Specialty Consultations
Warning:  Avoid reporting consultation codes for shared/split visitsConsultation codi... Read more
Say Goodbye to Consultations' 3 R's--Now There Are 4
Standard request form will help ensure you meet all the requirementsIn addition to the est... Read more
Overcome Critical Care Coding Dilemmas With These 3 Tips
Accurate time documentation is your first hurdleIf a patient doesn't exhibit a life-threat... Read more
Clip and Save:
Make Critical Care Coding Quick and Easy With This Chart
Less than 30 minutes means no critical care codeTack this simple chart on your wall to ens... Read more
Do Your Homework Before You Claim Operating Microscope
Medicare ususally won't pay 69990 for ENT surgeries, but others mightBefore you assign 699... Read more
READER QUESTIONS:
Look Beyond ICD-9's Code Descriptors
Question: My physician noted that a patient has -acute exacerbation of emphysema.- He also... Read more
READER QUESTIONS:
Avoid Temptation to Code Oxygen Administration
Question: When an office patient requires oxygen, what CPT code should I use for administe... Read more
READER QUESTIONS:
Don't Worry About Resubmitting 2006 Claims
Question: Will I need to resubmit the claims I have submitted in 2006 to claim the correct... Read more
READER QUESTIONS:
Report More Than Just Covered Services
Question: Should we bill exactly the same group of codes to all payers, or can we submit t... Read more
READER QUESTIONS:
Check Insurer Before Coding for Fluarix
Question: Our office is expecting a shipment of the Fluarix TIV influenza vaccine. When a ... Read more
READER QUESTIONS:
Code Based on Number of Venoms
Question: When our physician prepares 36 doses of three stinging insect venoms on the same... Read more
READER QUESTIONS:
Try Modifiers for ENG Claims
Question: I always report 92543 x 4 when our audiologist uses electroneurography (ENG) to ... Read more
READER QUESTIONS:
Include All Applicable Procedures in 69540
Question: Can I report both tympanostomy tube removal and aural polyp removal under genera... Read more
READER QUESTIONS:
NPPs Can Bill in Hospital--Just Not 'Incident-To'
Question: In your April article -Your Consult Documentation Needs Immediate Revision: Here... Read more
READER QUESTIONS:
Medicare Won't Pay 42145 With 42828
Question: Can we bill uvulopalatopharyngoplasty (UPPP, 42145) and tonsillectomy (42826) to... Read more
READER QUESTIONS:
Look to 0074T for Online Consults
Question: I read that we can charge insurers for our physician's online consultations, suc... Read more
READER QUESTIONS:
Don't Bill 99051 as a Stand-Alone Code
Question: Regarding CPT 2006's introduction of 99051, I have two questions:1. Should we us... Read more
You Be the Coder:
What Criteria Determine Vaccine Coding?
Question: What codes should I report for pneumonia vaccinations given in our office?New Ha... Read more
YOU BE THE CODER:
How Should We Code Zenker's Diverticulum?
Question: Which code should we report for surgical excision of a Zenker's diverticulum? Ou... Read more
3 Case Studies Clear Away Excision Coding Confusion
There's a simple trick to reporting re-excisions during the global periodCoding all servic... Read more
How to Avoid Excision/Biopsy Confusion
Keep in mind that a tissue biopsy as described by 11100 (Biopsy of skin, subcutaneous tiss... Read more
A Few Quick Questions Can Teach You About Critical Care
Not all ICU patients are critical, and not all critical patients are in the ICUIf reportin... Read more
READER QUESTIONS:
HEM Now Counts for Nursing Care
Question: Our ENT recently performed a re-admission assessment for a nursing home patient.... Read more
READER QUESTIONS:
NCCI Affects Sinusotomy/Sinus Endoscopy Claims
Question: May we report a sinusotomy separately when the ENT performs this procedure to re... Read more
READER QUESTIONS:
Classify Sleep Apnea When You Can
Question: What is organic sleep apnea? My physician has been using 780.57 to report sleep ... Read more
READER QUESTIONS:
Column 'Z' Reveals Supervision Requirements
Question: Our practice employs an audiologist who performs audiological tests off-site fro... Read more
You Be the Coder:
Is Meatoplasty Incidental to Tympanoplasty?
Question: Is meatoplasty (69310) incidental to tympanoplasty (69646), or should I appeal i... Read more
Reporting FEES or FEEST? Here's Crucial Information You Need
Warning:  Avoid 92520 with 92612-92616Although CPT added a host of new codes for fibe... Read more
Alert Your Payers:
64613 Applies For Laryngeal Botox Injections
You may be able to receive separate reimbursement for guidance, with appealChanges to CPT ... Read more
3 Examples of Time-Based Coding Get Time on Your Side
Refer to the 'reference time' for counseling and coordination of careWhen reporting servic... Read more
Clip and Save:
Quick-Reference Critical Care Chart
Make reporting critical care easy with this simple chart. Check the physician's documented... Read more
READER QUESTIONS:
Where the Scope Ends Up Determines Coding
Question: The ENT examines a child for airway obstruction. He inserts the scope through th... Read more
READER QUESTIONS:
Microscope Isn't Separate for Follow-up
Question: An otolaryngologist in our group practice wants to report 92504 every time he lo... Read more
READER QUESTIONS:
Paper Claim Doesn't Have to Mean Slow Filling
Question: Our payer says we are not in compliance with -timely filing- requirements when w... Read more
READER QUESTIONS:
Endoscopic ZD Calls for Unlisted-Procedure Code
Question: Is 43130 correct for an endoscopic staple-assisted Zenker's diverticulectomy? Th... Read more
You Be the Coder:
Does 'Secondary' Matter for Adenoidectomy?
Question: When reporting adenoidectomy with tonsillectomy, does it matter if the adenoidec... Read more
Your Consult Documentation Needs Immediate Revision:
Here's Why
Consulting physicians can ease the burden with fax-back sheet to requester In the past, y... Read more
Use This Sheet to Coordinate Your Consult Documentation
New Medicare rules outlined in Medlearn Matters article MM4215 stipulate that both the con... Read more
Case Study:
3 Examples Show You How to Maximize Tube Removals
Tympanic repair will call for separate procedure coding Although you-ll generally include... Read more
Why 'Unrelated' Might Not Mean What You Think It Means
Don't treat every infection as related to surgery, at least for private payers Before dec... Read more
CPT 2006 Update:
Change How You Report Drug Administrations -- or Face Denials
AMA deletes several procedure codes and G codes, replacing them with multiple new codes I... Read more
Learn the New CPT Injection Code Specifics
The American Medical Association CPT Editorial Board deleted seven injection and infusion ... Read more
AMA Consult Code Changes Give You Higher Pay-Up
AMA also clarifies what documentation you need for modifier 25 You now have fewer codes t... Read more
CPT 2006 Update:
Strengthen Your Asthma Coding With 1005F and 4015F
Although they have no RVUs, these codes support your physician's asthma services CPT 2006... Read more
NCCI 12.0 Update:
Reporting Nurse Visits With Immunizations? Not Anymore
Don't worry too much because new rule won't lead to denials, experts say If you-re report... Read more
4 Basic Steps Guarantee You'll Choose Correct Flu Shot Codes
Use this checklist to determine the correct vaccine and administration codes With differe... Read more
Reader Questions:
MRND Coding Depends on Payer
Question: How can we report a modified radical neck dissection (MRND) with laryngectomy? S... Read more
Reader Questions:
Any Doctor Can Use ED Codes
Question: An emergency department (ED) physician asked our ENT to see a patient who has se... Read more
Reader Questions:
Cut the Modifier 52/Modifier 53 Confusion
Question: How do we know if an -unsuccessful- procedure is reduced or discontinued?For ins... Read more
Reader Questions:
Make Sure You Have a Fifth Digit for Asthma Dx
Question: When reporting an asthma diagnosis, do I need a fifth digit?North Carolina Subsc... Read more
Reader Questions:
Don't Separately Report Nebulizer, Vaccine Supplies
Question: May we bill private payers for a syringe code with a vaccine administration code... Read more
Reader Questions:
Avoid the Sting of Venom Injection Denials
Question: When my physician administers two separate venoms (for example, honeybee and yel... Read more
Reader Questions:
Don't Lose Sleep Over Overnight Oximetry Coding
Question: Can I bill 94762 when a patient does this at home? Our office owns the equipment... Read more
You Be the Coder:
How Should I Report Salivary Stone Removal?
Reviewed on May 15, 2015 Question: How should I report removal of salivary stones fr... Read more
You Be the Coder:
Classify Sleep Apnea When You Can
Question: What is organic sleep apnea? My physician has been using 780.57 to report sleep ... Read more
Stumped by the Difference Between 31575 And 92511? Here's How to Tell Them Apart
Choosing the correct code can make a difference of $50 When you-re attempting to dist... Read more
Nasal Endoscopy Evaluates Whole Nasal Cavity
Another code you can easily confuse with 92511 is 31231 (Nasal endoscopy, diagnostic, unil... Read more
Multiple Scopes Usually Won't Mean Multiple Codes
Even modifiers 59 can't help you with 92511, 31231 bundleYour ENT may perform several endo... Read more
Make Modifier 78 Work for You
If you're treating Medicare and private payers the same, you're losing paymentsIf you-re i... Read more
Use This Chart to Simplify Your Post-Op Complications Coding
When your ENT treats postoperative complications (such as an infection of the surgical wou... Read more
READER QUESTIONS:
Include Evaluation With Scheduled Procedure
Question: The ENT meets with a patient and recommends a nasopharyngoscopy, which the patie... Read more
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 service?Ma... Read more
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 obser... Read more
READER QUESTIONS:
Extra Cleaning Earns Intermediate Repair
Question: Our ENT removed extensive debris from a wound that then required a single-layer ... Read more
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, the pati... Read more
READER QUESTIONS:
Strike 90788 From Your Code Choices
Question: We-ve received notice from our payers that 90788 is invalid after Dec. 31, 2005.... Read more
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... Read more
You Be the Coder:
Is an E/M Correct for TB Skin Tests?
Question: I-ve heard conflicting information on coding tuberculosis skin tests. Should we ... Read more
New 'or Telescope' Language Changes Your Laryngoscopy Coding
Treat telescope and operating microscope as equals You-ll no longer have to question the c... Read more
CPT 2006 Shows More Skin--And Your Practice Will Benefit
You'll have to differentiate between layers of skin when applying graft codesWith a host o... Read more
3 Tips Minimize Modifier 25 Mishaps
Keep your E/M and procedure documentation apartEvery time you fail to report a legitimate,... Read more
Be Sure You Don't Confuse Modifier 25 With 24, 57
Primary-procedure global days can guide you to correct applicationYou should append modifi... Read more
Good News:
CPT Makes Rest Home Services Coding Easier
You'll need 3 of 3 key components to choose a service level for new patientsIf you-re codi... Read more
READER QUESTIONS:
Count Readmission as Separate Service
Question: The ENT discharges a patient from the hospital and readmits the patient to the s... Read more
READER QUESTIONS:
Visualization With Tube Change Doesn't Call for 69990
Question: Can we report 69990 if the surgeon uses the operating microscope during a tube c... Read more
You Be the Coder:
How Do You Code Bilateral Membrane Repair?
Question: During removal of tubes (69424), our otolaryngologist also repaired the tympanic... Read more
Get the Upper Hand on Inferior Turbinate Codes
You must bundle cautery to same-session excision or submucous resectionYou should now limi... Read more
CPT Says, 'If You Don't Use It, You Lose It,' to 31585, 31586
E/M codes now the choice for closed laryngeal fracture careYou should no longer turn to 31... Read more
Medicare Cuts Conversion Factor 4.4% for 2006
Congress could still take action to prevent decreased paymentsYou can expect your payments... Read more
Get a Grip on Conscious Sedation Once and for All
-Appendix G- can tell you when to bundle CSCPT 2006 includes a major overhaul of conscious... Read more
6 New Codes Expand Your Conscious Sedation Options
Documentation becomes even more critical with new codesRevisions in CPT 2006 mean you will... Read more
Medicare Payers Will Continue to Bundle CS
In years past, Medicare considered conscious sedation procedures 99141-99142 bundled servi... Read more
CPT Quick Update:
Revise Your Consult Coding Jan. 1
You can't report a consult if the patient requests the serviceBecause CPT 2006 deletes fol... Read more
READER QUESTIONS:
Deciding Between 22 and Unlisted-Procedure Code
Question: How should I determine when to report a specific CPT code with modifier 22 rat... Read more
Coming Next Month:
More CPT 2006 Information
Look to the February 2006 Otolaryngology Coding Alert for even more valuable information o... Read more
Differentiate Between G0355 and 90782 for Precise Xolair Injection Coding
Follow these expert tips to discover why you shouldn't use 99211, 95115 or 95117To accurat... Read more
ICD-9 Introduces 21 New Sleep-Problem Diagnoses
The 327 series offers an alternative to unspecified insomnia, apnea diagnosesThe new ICD-9... Read more
Don't Lose Sleep Over Sleep Studies, Polysomnography
Our experts explain 95805-95807 versus 95808-95811When your allergist sends a patient for ... Read more
Know When to Report High-Level Established Patient Visits
Let history, medical necessity determine your code selectionMake sure your physician's doc... Read more
READER QUESTIONS:
Look to Lesion Excision for Mole Removal
Question: What is the appropriate code for -removal of mole-? I-ve searched the entire CPT... Read more
READER QUESTIONS:
SNF Patients Require Cooperation With the Facility
Question: Medicare is retracting payment for hearing tests if the patient came from a skil... Read more
READER QUESTIONS:
Don't Report Consult Without Documented Request
Question: My allergist had a patient schedule his own appointment and come into the office... Read more
READER QUESTIONS:
Report J7613 for Each Nebulizer Treatment
Question: A patient with acute asthma requires three same-visit nebulizer treatments to co... Read more
READER QUESTIONS:
Your Allergist or NP Must Document Patient's HPI
Question: My coworker thinks an allergist must take a patient's history, but I think a nur... Read more
READER QUESTIONS:
Oximetry Coverage Varies by Carrier
Question: Under what circumstances will insurers reimburse 94760? Can we report this code ... Read more
You Be the Coder:
Which Modifiers Will You Need?
Question: A patient came to our office with a new complaint five weeks after having had a ... Read more
You Be the Coder:
In-Office Nebulizer and At-Home Education
Question: My allergist saw an established patient who was newly diagnosed with asthma and ... Read more
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