Category: CC-Otolaryngology

If I see a new patient (9920x) for an ear problem, then they come back to see me for chronic sinusitis a year later, can I bill as a new patient visit (9920x) the second time or is it an established patient (9921x)?

Does use of a tissue adhesive “count” as a layer for the laceration repair codes?

When I bill an E/M code such as, a new patient or established patient visit, do I need to append modifier 25 when I also bill for an audiogram?

Someone told me to bill an E/M code like 99212 or 99202, instead of 69210 when removing impacted cerumen with instrumentation. What do you think?

I heard you say at a course (you were great, by the way, I learned a lot from you!) that we should wait for a pathology report before billing for excision of skin lesions. Please explain why. This may be why I’m not getting paid.

January 14, 2016 Question: I am trying to come up with the right CPT codes for a repair of nasal vestibular stenosis so we can get it pre-certified. Can you help? Answer: Yes, you are wise to determine the correct codes for pre-certification, otherwise the surgery might not be paid if you billed different codes. ...

I was in attendance at the "top ten coding issues" talk that you gave in Dallas at the AAOHNS annual meeting. Great talk, Kim! We spoke regarding CPT 69210 after the session. I just want to confirm that use of magnification is not necessary for this code. My associates insist that 69210 requires using the operative microscope. I realize that simple lavage doesn’t qualify, but I use illumination and instruments and or suction. What is correct?

We are thinking about starting an endoscopic skull base surgery program and doing skull base procedures via an expanded endonasal/endoscopic approach. I’ve looked in the CPT book for codes and it looks like CPT 61580-61619 are just what I’m looking for. Is this correct?

I just wanted to verify the guidelines for billing cerumen removal (69210). Before, it needed to state that the cerumen was “impacted” to be able to bill CPT 69210. I was just told that guideline has changed and that anything that goes in the body (I’m thinking like a curette to remove cerumen), even if it is not impacted, is now billable. Is this correct?

If I use one of the new ICD-10-CM codes for otitis media, do I still need to use the CPT modifier 50 for bilateral procedures when I bill for tympanostomy tube placement (69436)?