Category: CC-Otolaryngology

Sentinel Node Identification
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Sentinel Node Identification

August 22, 2019 Question: We have a new ENT and he’s doing a procedure my other guys don’t perform.  The patient goes to radiology for injection of radioactive isotopes then to the operating room where he then excises the skin cancer and then injects blue dye and uses a gamma probe to identify a sentinel...

Skin Biopsy Codes
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Skin Biopsy Codes

August 8, 2019 Question: What happened to the skin biopsy codes?  I submitted a claim for 11101 (skin biopsy) and +11101 (additional lesion) and it was denied for “invalid code.” Answer: CPT deleted CPT codes 11100 and +11101, effective 1/1/19, and replaced them with the follow six new codes: 11102  Tangential biopsy of skin (eg,...

Using G0268 for Cerumen Removal
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Using G0268 for Cerumen Removal

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...

Denials for Postop ESS Debridements
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Denials for Postop ESS Debridements

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...

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