September 17, 2020 Question: I work with an ENT and we don’t see many Medicare patients. The ENT believes the revised 2021 E/M guidelines will not impact our office practice because of our low Medicare volume. Is this correct? Answer: This is not correct! The revised documentation requirements are from CPT – the coding rule....
September 3, 2020 Question: I sent a patient out to the hospital for a CT scan and the patient brought in the actual images and the radiologist’s report for me to review. Can I charge 76140 (Consultation on X-ray examination made elsewhere, written report) when I personally interpret those images and write my own report?...
August 20, 2020 Question: My physician is utilizing an open laceration on the patient’s chin for open reduction of a mandibular symphysis fracture and he wants to also charge for a complex laceration repair for that laceration. Is this billable or is it part of the ORIF code? Answer: If the fracture is repaired through...
August 6, 2020 Question: Our coder recently attended one of your coding courses and her takeaway was that it was better to bill cerumen removal using an E/M code rather than 69210. Do you remember that discussion? Do you agree? Answer: No – good grief! This is an example of “people hear what they want...
July 23, 2020 Question: When I do an endoscopic septoplasty would I report both 31231 (nasal endoscopy) and 30520 (septoplasty)? Answer: We do not recommend reporting both codes. CPT says CPT 31231 (nasal endoscopy) denotes a “separate diagnostic procedure”. As such, it is not separately reported if any nasal/sinus definitive procedure (such as a septoplasty)...
July 9, 2020 Question: I took out 3 deep cervical nodes for biopsy on the left side. Can I bill 38510 x 3? Answer: No – you’d report 38510 once for any number of nodes removed from the same incision. *This response is based on the best information available as of 07/09/20.
June 25, 2020 Question: We are starting to do cosmetic facial plastic procedures in our ENT practice. How do I code/bill a cosmetic procedure such as a rhinoplasty versus when it gets billed to insurance? Answer: We recommend practices use a dummy code to track cosmetic procedures in the practice management system. For example, a...
June 11, 2020 Question: Are we able to bill for laryngeal nerve monitoring with thyroidectomy procedure? Answer: No – CPT is very clear in that intraoperative monitoring (e.g., 95940, 95941) is included in the global surgical package for the surgeon and should not be separately reported. *This response is based on the best information available...
May 28, 2020 Question: Can we charge a 31231 and a 30901, 30903, or 30905 if the scope is withdrawn and then the cautery is done? Answer: No. CPT 31231 is a diagnostic procedure and includes the parenthetical statement “separate procedure.” That means 31231 is included in a more definitive therapeutic/treatment procedure at the same...
May 14, 2020 Question: In an effort to phase our office “re-opening” to patients during the COVID pandemic, allergy serum that needs to be mixed in preparation must be done and at times there may not be on-site direct supervision by a physician or QHP. Medicare states direct supervision is required. Can we use virtual...
