Otolaryngology Coding Alert

Allergy Supervision:
Nail Down Supervision Requirements for Allergy Tests With a Few Quick Tips
Diagnostic test supervision differs from incident-to supervision. You've memorized the su... Read more
Compliance:
Find out How an Internal Audit Can Help You Avoid This ENT’s Fate
Hint: You'll find many ways to improve your payment processes. If you've never reviewed... Read more
Seasonal Coding:
Check 4 Quick Tips for Flawless Winter Diagnosis Coding
Check these instructions and guidelines you need to make it through the season. The temp... Read more
Reader Questions:
Evaluate How to Code Vaccine Side Effect
Question: How do we code an adverse reaction to a COVID-19 vaccine that was noted by... Read more
Reader Questions:
Differentiate 31237 From 30117
Question: Our ENT physician performed a septoplasty (30520) and excised a papilloma i... Read more
Reader Questions:
Understand the Rules Around Free Samples
Question: In the past, otolaryngologists in our practice have frequently supplied fr... Read more
You Be the Coder:
Can You Report an Initial Hospital Visit for Readmission?
Question: Our otolaryngologist saw a patient on September 6 in the hospital, and we b... Read more
Modifier 25:
Meet This Key Criterion to Use Modifier 25
Confusion reigns now that history and physical don't help drive E/M level — but we've go... Read more
Medicare Errors:
Lab Requests Rank Among This Payer’s Biggest Error-Prone Areas
Plus: Other common Part B errors involved E/M coding, care management. If you've ever won... Read more
Fee Schedule Proposal:
New Monitoring, Care Management Services Could Take Shape in 2022
Understand how remote therapeutic monitoring and principal care management could impact y... Read more
Reader Questions:
Understand MDM Table Differences
Question: Thank you for your article on medical decision making (MDM) last month. I have a... Read more
Reader Questions:
An Inpatient Remains an Inpatient Until Discharge
Question: We were asked to evaluate a hospital inpatient who was wheeled via gurney to our... Read more
Reader Questions:
Understand the Latest on 99211
Question: What are the minimum documentation requirements needed to bill 99211? What has t... Read more
You Be the Coder:
Understand How Many 92537 Units to Bill
Question: When we bill 92537, does that code represent the four irrigations as one unit or... Read more
CPT® 2022:
Check Updates to 99211, Nasal Fracture Treatment Codes Effective Jan. 1
Fortunately, the latest edition of CPT® isn't as earth-shattering as last year's. When t... Read more
Documentation:
‘Think in Ink’ to Nail MDM When Coding E/M Charts
Check these expert tips to tally the number and complexity of problems addressed. As otol... Read more
Nosebleed Coding:
5 Key Tips Help You Code Nasal Hemorrhages With Ease
Hint: Differentiate simple from complex to nail the coding rules. When patients present... Read more
Reader Questions:
Non-Medicare Payers May Perform Audits
Question: We treat pediatric patients who require otolaryngology care, so we don't submit ... Read more
Reader Questions:
Check Fee Schedule for Medicare Payment Amounts
Question: I noticed in your last issue that you shared a typical Medicare reimbursement am... Read more
Reader Questions:
Know How to Code Laryngitis
Question: Which code should we report for laryngitis? Tennessee Subscriber Answer: The a... Read more
Reader Questions:
How Far Back Should History Go?
Question: Our provider documented that a patient had “childhood measles 10 years ago.”... Read more
Reader Questions:
States May Dictate e-Signature Rules
Question: Our small practice still sees a majority of our Medicare benefi­ciaries via tel... Read more
You Be the Coder:
Understand How to Report Mixed Hearing Loss
Question: Which code should we report for mixed hearing loss? Florida Subscriber Answe... Read more
ICD-10-CM Coding:
Check New Codes for COVID-19, Cough With Hemorrhage, and More
Plus: You'll find expanded coding options for dysphagia, immunization counseling, and more... Read more
Part B Payments:
Otolaryngologists Could See Cuts Under Proposed Fee Schedule
But telehealth pay could continue into 2023, if the proposal is finalized. Otolaryngolo... Read more
E/M Coding:
6 Ways to Shore up Your Inpatient E/M Codes
Remember: Subsequent inpatient care is reported on a per-day basis. When your otolaryngol... Read more
Reader Questions:
Ask for All Insurance Cards at Every Visit
Question: Thanks for your article last month about appeals. One of the points was to check... Read more
Reader Questions:
Ask Providers for More Info, But Don’t Ask Leading Questions
Question: One of our newer otolaryngologists often creates documentation that's missi... Read more
You Be the Coder:
Does 42825 Involve Sutures?
Question: Our otolaryngologist performed a tonsillectomy and a primary closure of a tonsil... Read more
Compliance:
CMS: Otolaryngologists Responsible for Millions in Incorrect Coding Errors
Medicare reviewers revealed details about the latest Part B E/M improper payment rates. O... Read more
Get a Handle on CMS’ Review Benchmarks
CMS identified a total of $25.74 billion in improper payments among providers sampled in t... Read more
Appeals:
5 Facts Help You Boost Your Appeals Success Rate
Hint: Always know why you're appealing a claim before you hit ‘submit.' Appealing clai... Read more
HIPAA:
Avoid Privacy Breaches With a Few Key Tips
You should take HIPAA seriously — because insurers do. Ever wonder whether the governme... Read more
Reader Questions:
Check out How to Report Allergy Injection, But Not Supplies
Question: A patient came into our practice with her own allergy medication and asked our E... Read more
Reader Questions:
Avoid Modifier 59 on E/M Codes
Question: We reported 99212 with an injection code, and appended modifier 59 to the claim,... Read more
You Be the Coder:
Differentiate Primary Adenoidectomy From Secondary
Question: We are confused about the difference between primary (42830) and secondary (4283... Read more
ICD-10-CM:
Master These Tricky Malunion Fx 7th Character Reporting Guidelines
Do you know the difference between seventh characters A and P? Find out. Fracture coding... Read more
Guidelines:
Discern Between Manifestation, Sequela Diagnoses With 2 Examples
See what the guidelines say for COVID-19 manifestation reporting. While manifestation an... Read more
Modifiers:
Compare, Contrast Modifiers 52 and 53 for Terminated Surgeries
Here's how to handle a provider-planned reduction in service. When your otolaryngologist ... Read more
Reader Questions:
Include Ventilating Tube Removal in E/M Service
Question: Our provider removed a ventilating tube using a binocular microscope during an o... Read more
Reader Questions:
Follow These 2021 E/M Guidelines for Parent Consultations
Question: The 2021 revisions to the office/outpatient evaluation and management (E/M) code... Read more
Reader Questions:
Following This Recommended Consultation Coding Advice
Question: Our physician offered consultation services to a patient who was in treatment wi... Read more
You Be the Coder:
Know When Modifier 52 Works for 69210 Billing
Question: A patient arrived for an office visit for removal of cerumen in the right ear th... Read more
CPT® Guidelines:
Take a Deep Dive Into Access Pathway Concepts With This Guide
Drive the point home by coding a few clinical scenarios. If you haven't yet familiarized... Read more
E/M Coding:
Make Proper Distinctions Between These Hospital Care E/M Services
Compare and contrast 3 code ranges common to otolaryngology. If the varying sets of hospi... Read more
E/M Updates:
Check Out These Key Takeaway Points from 2021 E/M Updates
See how MDM data points and risk are redefined. The dust is starting to settle on the 20... Read more
Reader Questions:
Take This Approach for Visual-Turned-Audio Telehealth Visit
Question: Our otolaryngologist tried to conduct a telehealth evaluation and management (E/... Read more
Reader Questions:
Stick to 41105 for Posterior Tongue Core Needle Biopsies
Question: What's the CPT® coding for a needle core biopsy of the back of the tongue? I wa... Read more
Reader Questions:
Report This ICD-10-CM code for Diabetes 1.5
Question: Our provider recently documented a patient as having both type 1 and type 2 diab... Read more
Reader Questions:
Instruct Provider on Best Documentation Practices for 31231 Billing
Question: Is there anything I can do from a coding perspective to prevent 31231 bundling d... Read more
Reader Questions:
Take These Security Measures for Communication Via Unsecured Email
Question: Our patients frequently ask if we can send them appointment reminders or bills v... Read more
You Be the Coder:
Code Accordingly for Ear Wick Placements During Office Visits
Question: What's the CPT® code I would report for an ear wick replacement and removal dur... Read more
MIPS:
Get In-Depth Analysis on 2 Revised ENT MIPS Measures
Utilize these codes to maximize your provider's bottom line. Due to frequency of use, it'... Read more
ICD-10-CM:
Elevate Diagnosis Coding Processes With These Essential Pointers
Know when a provider query is warranted. Knowing your way around a provider chart or oper... Read more
Modifiers:
Fast Track Your Modifier 25 Claims With This Advice
Stick to the same script despite new 2021 E/M guidance. Knowing when, or even if, you can... Read more
Reader Questions:
Adhere to CPT® Advice for MDM Bullet Point Reporting
Question: For medical decision making (MDM) coding, should you count the order and review ... Read more
Reader Questions:
Rely on This Guidance for Smooth ABN Claims Processing
Question: Can you offer any guidance on how to properly submit advanced beneficiary notice... Read more
Reader Questions:
Know Criteria for 31256 to 31267 Conversion
Question: I'm working on a case where a patient presents for nasal endoscopy with a bilate... Read more
You Be the Coder:
Check Authoritative Guidance for Proper 20985 Billing
Question: We received a denial when submitting 20985 with bilateral maxillary and frontal ... Read more
CPT® Coding:
Elevate Your FESS Coding With a Detailed Walkthrough
Tackle each portion of the service with a step-by-step approach. The seemingly infinite w... Read more
Virtual Check-ins:
Simplify Your Virtual Check-in Coding With This Handy Guide
If the news coming out surrounding virtual check-in coding has your head swirling, you're ... Read more
Modifiers:
Apply Key Modifier 24 Guidance to These ENT Scenarios
2021 office/outpatient E/M changes won't affect its use, experts say. Knowing how to use... Read more
You Be the Coder:
Consider Overlapping Portions of Tracheostomies, Isthmus Resections
Question: Our provider performed a routine planned tracheostomy that includes the followin... Read more
Reader Questions:
Instruct Providers on Proper Op Report Documentation Requirements
Question: Our provider performed a bilateral myringotomy with tympanoplasty tube placement... Read more
Reader Questions:
Factor in New MDM Instruction on Prior Test Results
Question: If a provider is billing based on medical decision making (MDM), not on time, ca... Read more
Reader Questions:
Check Payer Guidance for Balloon Sinuplasty Prior Auth Requirements
Question: Our practice is looking to ensure that we have all the appropriate documentation... Read more
Reader Questions:
Add 99221-99223 to List of Eligible Telehealth Reporting Services
Question: Can we report inpatient telehealth evaluation and management (E/M) services to M... Read more
Allery Testing:
I.D. Guidelines for Same-Day E/M, Allergy Testing Services
Use a few takeaway points from two important CMS manuals. Procedural guidelines are desig... Read more
E/M 2021:
Get Formally Acquainted With Prolonged Services Code G2212
Consider a few key reasons for the switch from +99417. Over the course of 2020, you've w... Read more
Telehealth:
See How New PREP Act Amendment Affects Your Telehealth Coding
Use these tips to avoid making one of many common coding and billing mistakes. Telehealt... Read more
You Be the Coder:
Choose Between These Comparison Codes for Styloidectomy Procedures
Question: Our otolaryngologist performed a styloidectomy on a patient suffering from Eagle... Read more
Reader Questions:
Consider Revised 2021 ICD-10-CM Guidelines on Observation Sequencing
Question: Should we report the observation diagnosis codes (Z03-Z05) as primary diagnoses ... Read more
Reader Questions:
Factor in New MDM Guidance on Past Test Results
Question: If a provider is billing based on medical decision making (MDM), not on tim... Read more
Reader Questions:
Use Light Arithmetic for J2550 mL/mg Conversion
Question: We have a patient seen by our allergist that was given a promethazine inje... Read more
Final Rule:
Prep for Big Changes to Otolaryngology in 2021 MPFS Final Rule
Consider some important MIPS-related changes. The 2021 Medicare Physician Fee Schedule (M... Read more
Relief Bill:
See COVID-19 Relief Bill Effects on Bottom Line & More
Rest easy after seeing this new code indefinitely suspended. With the long-anticipated CO... Read more
Evaluation and Management:
Answer These Pressing FAQs Surrounding Inpatient E/M Services
Break down the key features of each respective code range. Coding hospital-based evaluat... Read more
You Be the Coder:
Check Key Details of Op Note for Final Say on 31541
Question: What's the coding for a suspension microlaryngoscopy with excision and biopsy of... Read more
Reader Questions:
Report Codes Based on DOS, not Date of Claim Submission
Question: We have a patient who underwent a nasopharyngoscopy with a right-sided balloon e... Read more
Reader Questions:
Check These Billing Guidelines for NP Cerumen Removals
Question: Can impacted cerumen removal by lavage be performed by a nurse? Pennsylvania Su... Read more
Reader Questions:
Meet This Set of Criteria for Compliant Consultation Coding
Question: Our physician offered consultation services to a patient who was in treatment wi... Read more
CPT® Coding:
Highlight Benefits of New Auditory Evoked Potential Codes
See how added detail in the description can ease the coding burden. Auditory evoked poten... Read more
COVID-19:
Work Out 3 Common COVID-19 Diagnostic Case Studies
Not sure which ICD-10 code to list first? Consider these strategies. Sequencing COVID-19 ... Read more
E/M 2021:
Break Down MDM Coding for Office/Outpatient E/M in 2021
Consider provider's analysis and management among other variables. Your coding options fo... Read more
Reader Questions:
Stick Within the Confines of 31267 Code Description
Question: Can I report code 31267 when the surgeon only removes tissue from the ostium fol... Read more
Reader Questions:
Take These Steps for Claims Deemed Unprocessable
Question: We received an “unprocessable” claim from our Medicare Administrative Contra... Read more
Reader Questions:
Take These Steps for In-Office COVID-19 Swabs, Handling
Question: If a provider has a telehealth visit with a patient and the patient is then... Read more
Reader Questions:
Gain Additional Insights Into Modifier 22 Reporting
Question: In what instances should I consider appending modifier 22 to surgical claim... Read more
You Be the Coder:
Choose Appropriate Fourth, Fifth Characters for Azithromycin Allergic Reactions
Question: What's the diagnosis coding for a patient experiencing an allergic reaction (vom... Read more
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