May 23, 2019 Question: My work RVUs are down this year. I do a lot of inferior turbinate submucous resection surgery and I code 30140 (Submucous resection inferior turbinate, partial or complete, any method). I noticed that the wRVUs for 30140 are now 3.00 and last year they were 3.57. This is a big hit...
May 9, 2019 Question: When would I ever use G0268 for cerumen removal vs 69210? Answer: G0268 is a HCPCS II code for “Removal of impacted cerumen (one or both ears) by physician on same date of service as audiologic function testing” while CPT code 69210 says “Removal impacted cerumen requiring instrumentation, unilateral.” Historically, G0268...
April 25, 2019 Question: We are receiving denials for 31237, performed right after endoscopic sinus surgery, stating we did not get prior approval and there was no documentation stating the need for the debridement in my office notes. Have you heard of this? Answer: Yes. Some payors require precertification for this surgical procedure even when performed...
April 11, 2019 Question: I recently attended a coding course you taught and learned a lot – thank you! I will say though that I am slightly confused by one thing you said… a history in the op note? I have never put any history in an op note. Where do you put any kind...
March 28, 2019 Question: My billing service is waiting for the pathology report and assigning the diagnosis and procedure code for benign or malignant skin lesion removal. This I completely understand. However, they are asking me to amend my procedure note accordingly once the pathology report is back. This is a lot of extra work...
March 14, 2019 Question: If I do a cosmetic rhinoplasty and a functional septoplasty on a patient, should I document both procedures on the same operative note? Or should I document a separate operative note for each procedure? Answer: Good question! In KZA’s experience, it is best to document one operative note for all procedures...
February 28, 2019 Question: I have a question on billing for allergy testing. All this time, and for any patient getting allergy testing, ICD-10 code J30.1 (Allergic Rhinitis due to pollen) has been the diagnosis code we are using. At the recent KZA workshop ICD-10 code Z01.82 (encounter for allergy testing) could also be used, but...
February 14, 2019 Question: We routinely bill 69631 (tympanoplasty) and 20922 (temporalis fascia graft). We’ve been paid but now we’re being asked to give money back. Can you help? Answer: A thigh fascia lata graft was not harvested to support 20922. Rather, if a temporalis fascia graft is harvested through a separate skin incision then...
January 31, 2019 Question: My ENT did a direct laryngoscopy with 2 biopsies of a laryngeal tumor. Can we bill 31535 and 31535-59? Answer: No – the code includes any number of biopsies for that tumor. *This response is based on the best information available as of 1/31/19.
January 17, 2019 Question: We can’t get a revision rhinoplasty paid. Is it ok if we use the septoplasty code with modifier 22? Answer: No. These procedures should be prior authorized in writing to ensure payment. If you cannot obtain written approval from the payor prior to surgery, then we recommend you treat the patient...
