July 22, 2021 Question: We billed 31600 for a tracheostomy along with 41140 (total glossectomy). CPT 31600 was denied. How can we appeal? Answer: Good question, however, the denial was appropriate. CPT guidelines say that a tracheostomy is included in the glossectomy codes 41140 – 41155 as these procedures would not be performed without a...
July 8, 2021 Question: Are CPT 30140 (submucous resection inferior turbinate) and 31254 (endoscopic anterior ethmoidectomy) bundled with code 62165 (Neuroendoscopy, intracranial; with excision of pituitary tumor, transnasal or trans-sphenoidal approach)? I checked Medicare and there are no CCI edits so that seems that I can bill these codes together. The diagnosis code I billed...
June 24, 2021 Question: What is the CPT code for flexible laryngoscopy performed in the OR under anesthesia? Answer: Right now we have only 31575 for this procedure. If you are referring to a drug induced sleep endoscopy (DISE), be on the lookout for a code in 2022! *This response is based on the best...
June 10, 2021 Question: My physician is utilizing an open laceration on the patients chin for open reduction of a mandibular symphysis fracture. He wants to also charge for complex laceration repair for that laceration. Is this billable or is it part of the ORIF code? Answer: If the fracture is repaired through the laceration...
My 27, 2021 Question: Does 31231 (nasal endoscopy) have to be done with a rigid scope? Answer: The CPT descriptor for 31231 is: Nasal endoscopy, diagnostic, unilateral or bilateral (separate procedure). Notice it does not specify whether the scope must be rigid or flexible. That said, CPT makes it clear that the anatomic structures examined...
My 13, 2021 Question: A new patient had excessive dried blood and hematoma in the external ear canal. Under microscopy, the provider used an angled pick, alligator forceps and suction to remove the hematoma and dried blood debris. Is there an additional CPT that should be reported for the procedure? Answer: There is a not...
April 29, 2021 Question: If someone comes in for ear cleaning do you bill 69210 only or can you also bill an E/M code with modifier 25 and 69210? Answer: If the purpose of the encounter is for cerumen removal, as your scenario describes, then you would code only the cerumen removal (e.g., 69210). Have...
April 15, 2021 Question: Under the new E/M coding revisions for office visits, should we document time AND medical decision making for every visit? Answer: According to advice from the AMA (3/24/21 webinar), you should only document one or the other to prevent potential audit confusion and risk. Document time if billing by time OR...
April 1, 2021 Question: Would bilateral recurrent acute otitis media, on a patient that will need tympanostomy tubes, count as 2 problems in the new E/M guidelines for office visits? Answer: No because these two problems will have the same concurrent treatment (tympanostomy tubes). Therefore, it counts as 1 problem. *This response is based on...
March 18, 2021 Question: We have an in-house CT which has made me confused about how to count the data for the my ENT’s E/M code. Please help. Answer: Good question and let’s simplify things. The AMA specifically states there should be “no incentive”, related to E/M coding, to the physician for ordering tests. So...
