Otolaryngology Coding Alert

These endoscopy coding tips help you earn the most bang for your services. Get paid for separate side FESS and separate session epistaxis -- and stay off payers' audit radar, by correctly using one of the most misused modifiers: 59 (Distinct procedural service). 1: Reserve 59 for Breaking 'Different' Bundle The right combination of an otolaryngological procedure and a modifier can make or break your claim. "Every modifier tells a story," says Susan Ward, CPC, CPC-H, CPC-I, CPCD, CEMC, CPRC, coding and billing manager in Phoenix. Through modifiers, payers know what transpired in the operative process without having to read every operative report. Modifier 59 indicates that a distinct procedure has been performed during the same date. This modifier encompasses treatment for multiple primary, unrelated problems and may represent a different surgery, a different site, a different lesion, a different injury, or a different area of injury. Example: If the otolaryngologist performs [...]