Category: CC-Otolaryngology

Postop Endoscopic Sinus Debridements
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Postop Endoscopic Sinus Debridements

February 10, 2022 Question: If one of our physicians performed a septoplasty and sinus surgery and then the patient comes in the office for a 31237 (endoscopic sinus debridement), would we use a modifier 79 (unrelated procedure in a global period) or 58 (staged/anticipated procedure in a global)? Answer: You’ll use modifier 79. The debridements...

Why this NCCI Edit?
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Why this NCCI Edit?

January 27, 2022 Question: In the office, one of our physicians, performed 31296-50 (endoscopic dilation frontal sinus), 31295-50 (endoscopic dilation maxillary sinus) and 69706 (endoscopic eustachian tube dilation). The insurance is paying on the 31296 and 31295 but will not pay on the 69706 because Medicare considers it unbundled. Why is the ear procedure is...

Open Septoplasty
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Open Septoplasty

December 30, 2021 Question: What is the code for an open septoplasty? I’m doing extracorporeal work removing the septum and reinserting it.  It’s more difficult than a regular intranasal septoplasty, 30520. Answer: There is not a separate code for an open septoplasty – 30520 is all we’ve got. You could append modifier 22 (increased procedural...

Counting Problems Addressed for Medical Decision Making
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Counting Problems Addressed for Medical Decision Making

December 16, 2021 Question: If a patient has one stable chronic illness and one acute uncomplicated illness without systemic symptoms, can we “up” the level of Problems Addressed to Moderate for a new patient (99202-99205) or established patient (99212-99215)? Answer: No, sorry, unfortunately it doesn’t work that way.  The problems are no additive or cumulative. ...

Microscopy and Mastoid Debridement
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Microscopy and Mastoid Debridement

December 2, 2021 Question: We had a patient come in for a mastoid debridement using the microscope.  It is ok to bill 69220 for the debridement and 92504 for the microscope? Answer: No, the diagnostic binocular microscopy (92504) is included in the surgical/therapeutic debridement code (69220) and not separately reported.  In fact, 92504 is included...

NIM During Total Thyroidectomy
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NIM During Total Thyroidectomy

October 28, 2021 Question: Is 95940 (NIM – neurophysiologic intraoperative monitoring) separately billable with a total thyroidectomy? Answer: Intraoperative monitoring is not separately billable by the surgeon, per CPT guidelines. *This response is based on the best information available as of 10/28/21.        

Medical Decision Making Credit for Ordering an Audiogram
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Medical Decision Making Credit for Ordering an Audiogram

September 30, 2021 Question: My ENT doctor ordered an audiogram to be done by our audiologist. The doctor billed for the audiogram to a non-Medicare payor because the audiologist is not credentialled with that payor.  Can my doctor “get credit” for ordering and reviewing the audiogram when he chooses the E/M code level?  What happens...

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