Otolaryngology Coding Alert
Surgery Coding:
Focus on Procedure Type, Date of Surgery with Modifier 57
Identify all the key components for proper use of modifier 57. Sometimes, a physician may... Read more
Focus on Procedure Type, Date of Surgery with Modifier 57
Identify all the key components for proper use of modifier 57. Sometimes, a physician may... Read more
ICD-10 Coding:
Practice Makes Perfect: Work Out these Tricky ICD-10 Scenarios
Fall back on ICD-10-CM guidelines when the going gets tough. No coder is expected to full... Read more
Practice Makes Perfect: Work Out these Tricky ICD-10 Scenarios
Fall back on ICD-10-CM guidelines when the going gets tough. No coder is expected to full... Read more
Modifiers:
Test Your Modifier 25 Knowledge with these Examples
Know what circumstances do and don't warrant 25 use. Even the most seasoned coders will a... Read more
Test Your Modifier 25 Knowledge with these Examples
Know what circumstances do and don't warrant 25 use. Even the most seasoned coders will a... Read more
Reader Question:
Include Appropriate Documentation, Justification with Modifier 22
Question: We submitted a claim with modifier 22 because the surgeon spent an extra 50 minu... Read more
Include Appropriate Documentation, Justification with Modifier 22
Question: We submitted a claim with modifier 22 because the surgeon spent an extra 50 minu... Read more
Reader Question:
Refer to Appendix P for Telemedicine Codes
Question: How do I know which evaluation and management (E/M) codes are eligible for use a... Read more
Refer to Appendix P for Telemedicine Codes
Question: How do I know which evaluation and management (E/M) codes are eligible for use a... Read more
You Be the Coder:
Determine Sialolithotomy Complexity Using these Factors
Question: The surgeon performed a sub-mandibular sialolithotomy to remove multiple stones ... Read more
Determine Sialolithotomy Complexity Using these Factors
Question: The surgeon performed a sub-mandibular sialolithotomy to remove multiple stones ... Read more
CPT® Training:
Begin Preps Now for New 2018 CPT® Codes
Rely on this comprehensive list of all new otolaryngology CPT® changes. As all experienc... Read more
Begin Preps Now for New 2018 CPT® Codes
Rely on this comprehensive list of all new otolaryngology CPT® changes. As all experienc... Read more
Preventive Measures:
Know These Rules on Coding Obesity Screening, Counseling Measures
Consider obesity screening measures in these circumstances. Otolaryngologists, like most ... Read more
Know These Rules on Coding Obesity Screening, Counseling Measures
Consider obesity screening measures in these circumstances. Otolaryngologists, like most ... Read more
ICD-10 Training:
Master the Art of ENT Neoplasm Diagnosis Coding
Utilize these two examples to boost your diagnostic coding skills. Coding neoplasms of th... Read more
Master the Art of ENT Neoplasm Diagnosis Coding
Utilize these two examples to boost your diagnostic coding skills. Coding neoplasms of th... Read more
Reader Question:
Don't Assume Allergic Origin without Documentation
Question: A patient presents with acute otitis media of the left ear and an unspecifi... Read more
Don't Assume Allergic Origin without Documentation
Question: A patient presents with acute otitis media of the left ear and an unspecifi... Read more
Reader Question:
Factor in All of these Elements to Reach Extended HPI
Question: The patient complains of a sore throat for the past three weeks. It is usua... Read more
Factor in All of these Elements to Reach Extended HPI
Question: The patient complains of a sore throat for the past three weeks. It is usua... Read more
Reader Question:
Determine Appropriate Use of Technical, Professional Component
Question: Sometimes our provider will perform a computerized tomography (CT) maxillof... Read more
Determine Appropriate Use of Technical, Professional Component
Question: Sometimes our provider will perform a computerized tomography (CT) maxillof... Read more
You Be the Coder:
Code Unspecified for Mass of Nasal Cavity
Question: A patient is seen by the provider for a surgical consult to remove a nasal ... Read more
Code Unspecified for Mass of Nasal Cavity
Question: A patient is seen by the provider for a surgical consult to remove a nasal ... Read more
ICD-10:
Use These Tips to Avoid Allergy Coding Traps
Don't make allergy diagnosis coding more difficult than it has to be. Diagnoses involving... Read more
Use These Tips to Avoid Allergy Coding Traps
Don't make allergy diagnosis coding more difficult than it has to be. Diagnoses involving... Read more
CPT® Coding:
Know Your Anatomy, Distinguish Between these I&D Codes
Specificity is key when so many codes cover such a small anatomical area. When it comes t... Read more
Know Your Anatomy, Distinguish Between these I&D Codes
Specificity is key when so many codes cover such a small anatomical area. When it comes t... Read more
FAQs:
Rely on this Advice to Steer ABN Coding
Enhance your understanding of the ABN process by utilizing these FAQs. Putting a system i... Read more
Rely on this Advice to Steer ABN Coding
Enhance your understanding of the ABN process by utilizing these FAQs. Putting a system i... Read more
Reader Question:
Distinguish Between Various Degrees of Asthma Severity
Question: How do I distinguish between mild, moderate, and severe persistent asthma d... Read more
Distinguish Between Various Degrees of Asthma Severity
Question: How do I distinguish between mild, moderate, and severe persistent asthma d... Read more
Reader Question:
Focus on Style of Incision to Discern Between 41010 and 41520
Question: I'm having trouble distinguishing between codes 41010 and 41520. In what ci... Read more
Focus on Style of Incision to Discern Between 41010 and 41520
Question: I'm having trouble distinguishing between codes 41010 and 41520. In what ci... Read more
You Be the Coder:
Know the Difference Between Destruction and Excision Codes
Question: A patient presented with a left ear canal 9 cm vascular lesion. After debri... Read more
Know the Difference Between Destruction and Excision Codes
Question: A patient presented with a left ear canal 9 cm vascular lesion. After debri... Read more
Compliance:
Know the Ins and Outs of the ABN Billing Process
Use medical necessity and denial history as a gauge when issuing ABNs. Depending your deg... Read more
Know the Ins and Outs of the ABN Billing Process
Use medical necessity and denial history as a gauge when issuing ABNs. Depending your deg... Read more
CPT® Coding:
Consider Medicare Guidelines, Medical Necessity when Coding Rhinoplasties
Take each of these factors into account to simplify the coding and billing process. Speak... Read more
Consider Medicare Guidelines, Medical Necessity when Coding Rhinoplasties
Take each of these factors into account to simplify the coding and billing process. Speak... Read more
ICD-10 Coding:
Catch Up on these New and Revised ICD-10 Changes
Begin preparations now to hit the ground running on Oct. 1. Oct., 2017 will bring about a... Read more
Catch Up on these New and Revised ICD-10 Changes
Begin preparations now to hit the ground running on Oct. 1. Oct., 2017 will bring about a... Read more
Reader Question:
Avoid Modifier 50 on Laryngoscopies with Laser Lesion Removal
Question: Our physician performed a flexible laryngoscopy with laser removal and biop... Read more
Avoid Modifier 50 on Laryngoscopies with Laser Lesion Removal
Question: Our physician performed a flexible laryngoscopy with laser removal and biop... Read more
Reader Question:
Check Global Period for these Debridement Procedures
Question: A patient returns to the doctor’s office for a debridement of a tympa... Read more
Check Global Period for these Debridement Procedures
Question: A patient returns to the doctor’s office for a debridement of a tympa... Read more
You Be the Coder:
Be Cognizant of Rules Surrounding E/M Visits, 69210
Question: Can I bill for 69210 with an evaluation and management (E/M) visit if the p... Read more
Be Cognizant of Rules Surrounding E/M Visits, 69210
Question: Can I bill for 69210 with an evaluation and management (E/M) visit if the p... Read more
Coding Compliance:
Myth Busting: When to Bypass NCCI
Sometimes there’s more to bundling than just CCI edits. Many coders see the Nationa... Read more
Myth Busting: When to Bypass NCCI
Sometimes there’s more to bundling than just CCI edits. Many coders see the Nationa... Read more
ICD-10 Coding:
Cut Down on Denials, Cross Reference Unspecified Codes
Know beforehand which codes will and won’t be paid. Hindsight is always 20-20 when ... Read more
Cut Down on Denials, Cross Reference Unspecified Codes
Know beforehand which codes will and won’t be paid. Hindsight is always 20-20 when ... Read more
CPT® Coding:
Follow These 2 Steps to Secure Reimbursement on Unlisted Codes
Rely on this expert advice to help take the stress out of billing unlisted. Last month, y... Read more
Follow These 2 Steps to Secure Reimbursement on Unlisted Codes
Rely on this expert advice to help take the stress out of billing unlisted. Last month, y... Read more
Reader Question:
Don't Worry About Global Periods for Most FESS Procedures
Question: A patient had a functional endoscopic sinus surgery (FESS) six days ago. Th... Read more
Don't Worry About Global Periods for Most FESS Procedures
Question: A patient had a functional endoscopic sinus surgery (FESS) six days ago. Th... Read more
Reader Question:
Remember When to Bundle 60500 into 60240
Question: My insurance company always bundles 60500 into 60240. If the physician perf... Read more
Remember When to Bundle 60500 into 60240
Question: My insurance company always bundles 60500 into 60240. If the physician perf... Read more
Reader Question:
Consider Practicality, Chances of Success Before Appealing
Question: My provider follows by a philosophy that we should appeal all denials, rega... Read more
Consider Practicality, Chances of Success Before Appealing
Question: My provider follows by a philosophy that we should appeal all denials, rega... Read more
You Be the Coder:
Use Caution with Modifier 59 for Nasopharyngeal Excisions and Biopsies
Question: Using an adenoid curette instrument, a benign neoplasm is excised from the ... Read more
Use Caution with Modifier 59 for Nasopharyngeal Excisions and Biopsies
Question: Using an adenoid curette instrument, a benign neoplasm is excised from the ... Read more
CPT® Coding:
Go Unlisted in These 2 Scenarios
Know when an unlisted code is the best option. In numerous specialties, there is a genera... Read more
Go Unlisted in These 2 Scenarios
Know when an unlisted code is the best option. In numerous specialties, there is a genera... Read more
ICD-10 Coding:
Coding Sinusitis: Not as Simple as Chronic vs. Acute
Take other factors into consideration when coding sinusitis. Common sense might suggest t... Read more
Coding Sinusitis: Not as Simple as Chronic vs. Acute
Take other factors into consideration when coding sinusitis. Common sense might suggest t... Read more
ICD-10:
Check Out this Example of Proper Non-Indexable Disease Coding
For this salivary gland disease, follow these Dx coding rules. It’s fair to say tha... Read more
Check Out this Example of Proper Non-Indexable Disease Coding
For this salivary gland disease, follow these Dx coding rules. It’s fair to say tha... Read more
Reader Question:
Consider Pharyngeal Approaches to Eustachian Tube Dilations
Question: Our surgeon wants to code a pharyngoplasty, but I’m unsure as to whet... Read more
Consider Pharyngeal Approaches to Eustachian Tube Dilations
Question: Our surgeon wants to code a pharyngoplasty, but I’m unsure as to whet... Read more
Reader Question:
Report 1 Code for Tonsillectomy, Revision Adenoidectomy Combos
Question: We have a 5-year-old patient who received a tonsillectomy with a revision a... Read more
Report 1 Code for Tonsillectomy, Revision Adenoidectomy Combos
Question: We have a 5-year-old patient who received a tonsillectomy with a revision a... Read more
Reader Question:
Use 3-Month Timeframe When Coding Chronic Sore Throat
Question: A patient has come in with a sore throat for the past seven days. Would thi... Read more
Use 3-Month Timeframe When Coding Chronic Sore Throat
Question: A patient has come in with a sore throat for the past seven days. Would thi... Read more
Reader Question:
Rely on Crosswalk for Post-Tonsillectomy Hemorrhage Code
Question: What is the appropriate code for post-tonsillectomy hemorrhage? Pennsylvan... Read more
Rely on Crosswalk for Post-Tonsillectomy Hemorrhage Code
Question: What is the appropriate code for post-tonsillectomy hemorrhage? Pennsylvan... Read more
You Be the Coder:
Correctly Code Multiple Sinus Endoscopies
Question: A patient presents to the department for a functional endoscopic sinus surg... Read more
Correctly Code Multiple Sinus Endoscopies
Question: A patient presents to the department for a functional endoscopic sinus surg... Read more
MIPS Measures:
Keep In-Sync with Current MIPS Guidelines
Save yourself the hassle (and money) by making sure your practice is compliant with curren... Read more
Keep In-Sync with Current MIPS Guidelines
Save yourself the hassle (and money) by making sure your practice is compliant with curren... Read more
Putting MIPS to the Test
We’ve provided these 6 ENT-specific measures that your practice can utilize to keep ... Read more
We’ve provided these 6 ENT-specific measures that your practice can utilize to keep ... Read more
Procedure Coding:
Decode Draf Drainage Procedures
Here’s everything you need to know about Draf sinus procedures. If a patient suffer... Read more
Decode Draf Drainage Procedures
Here’s everything you need to know about Draf sinus procedures. If a patient suffer... Read more
ICD-10:
Abide By These Rules When Coding Foreign Bodies
Know when to apply these secondary codes. Foreign bodies (FBs) entering through one of th... Read more
Abide By These Rules When Coding Foreign Bodies
Know when to apply these secondary codes. Foreign bodies (FBs) entering through one of th... Read more
Reader Question:
Bundle Radical Dissections, Resections Based on Documentation
Question: The physician performed a modified radical neck dissection (38724) in addit... Read more
Bundle Radical Dissections, Resections Based on Documentation
Question: The physician performed a modified radical neck dissection (38724) in addit... Read more
Reader Question:
Sometimes, Two Words Make All The Difference In Descriptors
Question: Our physician performed a right submucosal resection of the inferior turbin... Read more
Sometimes, Two Words Make All The Difference In Descriptors
Question: Our physician performed a right submucosal resection of the inferior turbin... Read more
Reader Question:
Use ICD-10 Index, Reach Correct Thyroid Dx
Question: A patient diagnosed with hyperthyroidism was found to have an additional si... Read more
Use ICD-10 Index, Reach Correct Thyroid Dx
Question: A patient diagnosed with hyperthyroidism was found to have an additional si... Read more
You Be the Coder:
Compare and Contrast Two Kinds of Radical Neck Dissection
Question: How would you code a laryngectomy with bilateral modified radical neck diss... Read more
Compare and Contrast Two Kinds of Radical Neck Dissection
Question: How would you code a laryngectomy with bilateral modified radical neck diss... Read more
Procedure Coding:
Listen Up: Report Ear Drainage, FBR with Specific Codes
Here’s why the standard FBR codes don’t work for ear procedures. Coders at ot... Read more
Listen Up: Report Ear Drainage, FBR with Specific Codes
Here’s why the standard FBR codes don’t work for ear procedures. Coders at ot... Read more
E/M Coding:
NGS Set to Increase Some Exam Demands
Detailed exams are about to level up. Recently, the Medicare Administrator Contractor (MA... Read more
NGS Set to Increase Some Exam Demands
Detailed exams are about to level up. Recently, the Medicare Administrator Contractor (MA... Read more
Ask an Expert:
Use Modifiers XP, XU Only in Specific Situations
Here’s why your use of these modifiers will be rare. While CPT® still has modif... Read more
Use Modifiers XP, XU Only in Specific Situations
Here’s why your use of these modifiers will be rare. While CPT® still has modif... Read more
Reader Question:
Look to These Codes on Neck Dissections
Question: Encounter notes indicate that a patient reports to the otolaryngologist for... Read more
Look to These Codes on Neck Dissections
Question: Encounter notes indicate that a patient reports to the otolaryngologist for... Read more
Reader Question:
Avoid Medicare's Ire by Obeying Stark Laws
Question: I overheard one of our nonphysician practitioners (NPPs) tell a coder that someo... Read more
Avoid Medicare's Ire by Obeying Stark Laws
Question: I overheard one of our nonphysician practitioners (NPPs) tell a coder that someo... Read more
You Be the Coder:
Coding Allergy/Sinus Testing
Question: A primary care physician (PCP) referred a patient to our otolaryngologist f... Read more
Coding Allergy/Sinus Testing
Question: A primary care physician (PCP) referred a patient to our otolaryngologist f... Read more
Procedure Coding:
Mind Patient's Age, Procedure's Locale on Tonsillectomy/Adenoidectomy Claims
Know the age cutoff for these surgical codes. When your otolaryngologist performs a tonsi... Read more
Mind Patient's Age, Procedure's Locale on Tonsillectomy/Adenoidectomy Claims
Know the age cutoff for these surgical codes. When your otolaryngologist performs a tonsi... Read more
Shared Services:
Use This Guide to Ferret Out Shared Visit, Incident-to Opportunities
Remember, incident-to requires an established plan of care. When a physician and a nonph... Read more
Use This Guide to Ferret Out Shared Visit, Incident-to Opportunities
Remember, incident-to requires an established plan of care. When a physician and a nonph... Read more
E/M Coding:
Get to Know PFSH to Beef Up Your History Coding Smarts
You’ll choose between two kinds of PFSH for each E/M. Coders that find a challenge ... Read more
Get to Know PFSH to Beef Up Your History Coding Smarts
You’ll choose between two kinds of PFSH for each E/M. Coders that find a challenge ... Read more
Reader Question:
Leave Lavage off Endoscopy Claim
Question: Our otolaryngologist recently performed a sinus endoscopy, during which she... Read more
Leave Lavage off Endoscopy Claim
Question: Our otolaryngologist recently performed a sinus endoscopy, during which she... Read more
Reader Question:
Check Appendix P for Telemedicine Coding Guidance
Question: Is there a list of codes that are eligible for use with telemedicine servic... Read more
Check Appendix P for Telemedicine Coding Guidance
Question: Is there a list of codes that are eligible for use with telemedicine servic... Read more
You Be the Coder:
Reporting Caloric Vestibular Tests
Question: Encounter notes indicate that the otolaryngologist performed a bithermal ca... Read more
Reporting Caloric Vestibular Tests
Question: Encounter notes indicate that the otolaryngologist performed a bithermal ca... Read more
Procedure Coding:
Opt for 1 of 3 Coding Choices on Earwax Removal
Here’s who CPT® designed the new 69209 code for. A patient reports to the otola... Read more
Opt for 1 of 3 Coding Choices on Earwax Removal
Here’s who CPT® designed the new 69209 code for. A patient reports to the otola... Read more
Modifiers:
Study Code Descriptors to Arrive at Modifier 50 Decision
‘Bilateral’ in descriptor means modifier 50’s a no-no. At times, an oto... Read more
Study Code Descriptors to Arrive at Modifier 50 Decision
‘Bilateral’ in descriptor means modifier 50’s a no-no. At times, an oto... Read more
ICD-10 Coding:
Check Payer Policy for Acceptable Ethmoidectomy Dx
Experts: Some payers have specific set of ICD-10s that allow for ethmoidectomy. When it c... Read more
Check Payer Policy for Acceptable Ethmoidectomy Dx
Experts: Some payers have specific set of ICD-10s that allow for ethmoidectomy. When it c... Read more
Reader Question:
Get Accurate Test Count on ENG Claims
Question: Encounter notes indicate that the otolaryngologist performed an electronyst... Read more
Get Accurate Test Count on ENG Claims
Question: Encounter notes indicate that the otolaryngologist performed an electronyst... Read more
Reader Question:
Warn Physicians Off 'Automatic' E/M Coding
Question: I am having an issue with one of our physicians who wants to report almost ... Read more
Warn Physicians Off 'Automatic' E/M Coding
Question: I am having an issue with one of our physicians who wants to report almost ... Read more
You Be the Coder:
Coding Laryngeal Botox Injections
Question: Encounter notes indicate that the otolaryngologist performed a direct laryn... Read more
Coding Laryngeal Botox Injections
Question: Encounter notes indicate that the otolaryngologist performed a direct laryn... Read more
Procedure Coding:
Mind Method, Area on Ethmoidectomies
Use this FAQ to Keep ethmoidectomy types separate. When your otolaryngologist perform... Read more
Mind Method, Area on Ethmoidectomies
Use this FAQ to Keep ethmoidectomy types separate. When your otolaryngologist perform... Read more
Ask an Expert:
Check Out These Cases to Master X Modifiers
Some payers still want modifier 59, but others will crave specificity. In 2015, Medica... Read more
Check Out These Cases to Master X Modifiers
Some payers still want modifier 59, but others will crave specificity. In 2015, Medica... Read more
E/M Coding:
Code Prolonged Services After Discovering the Provider
CPT® has different codes for different ‘clinical staff.’ If your otola... Read more
Code Prolonged Services After Discovering the Provider
CPT® has different codes for different ‘clinical staff.’ If your otola... Read more
Reader Question:
Use These Pointers, Ace Locum Tenens Claims
Question: Our otolaryngology practice recently hired a locum tenens (LT) physician ... Read more
Use These Pointers, Ace Locum Tenens Claims
Question: Our otolaryngology practice recently hired a locum tenens (LT) physician ... Read more
Reader Question:
Consider Oral Pain Med Part of E/M
Question: When one of our providers administers oral pain medication such as acetam... Read more
Consider Oral Pain Med Part of E/M
Question: When one of our providers administers oral pain medication such as acetam... Read more
You Be the Coder:
Coding for Tympanostomy, Tube Removal
Question: How should we code for in-office insertion of ventilating ear tubes (tymp... Read more
Coding for Tympanostomy, Tube Removal
Question: How should we code for in-office insertion of ventilating ear tubes (tymp... Read more
ICD-10 Coding:
Spot Different Rhinitis Types with These Dx Tips
Use chronic codes for patients with rhinitis for 12-plus weeks. Otolaryngology practic... Read more
Spot Different Rhinitis Types with These Dx Tips
Use chronic codes for patients with rhinitis for 12-plus weeks. Otolaryngology practic... Read more
ICD-10 Coding:
Use 1 More Code to Finish Some Rhinitis Diagnoses
Chronic rhinitis patient? Check tobacco exposure level. When you are choosing the corr... Read more
Use 1 More Code to Finish Some Rhinitis Diagnoses
Chronic rhinitis patient? Check tobacco exposure level. When you are choosing the corr... Read more
Modifiers:
Choose From 59/X After Separating Procedures
Payer preference still drives 59/X decision. Coders confronted with claims in which th... Read more
Choose From 59/X After Separating Procedures
Payer preference still drives 59/X decision. Coders confronted with claims in which th... Read more
Reader Question:
Note Insurer to Keep HPI Counts on Point
Question: An established patient reports to the otolaryngologist with a chief compl... Read more
Note Insurer to Keep HPI Counts on Point
Question: An established patient reports to the otolaryngologist with a chief compl... Read more
Reader Question:
Find Face-to-Face Evidence Before Coding 99217
Question: The otolaryngologist meets an established patient at the hospital with sy... Read more
Find Face-to-Face Evidence Before Coding 99217
Question: The otolaryngologist meets an established patient at the hospital with sy... Read more
Reader Question:
Get Specific with Pharyngitis Code Choice
Question: When our otolaryngologist diagnoses acute pharyngitis, how should I choos... Read more
Get Specific with Pharyngitis Code Choice
Question: When our otolaryngologist diagnoses acute pharyngitis, how should I choos... Read more
You Be the Coder:
Coding E/M with Earwax Removal
Question: I have been looking at the earwax removal code 69209 (Removal impacted ce... Read more
Coding E/M with Earwax Removal
Question: I have been looking at the earwax removal code 69209 (Removal impacted ce... Read more