Otolaryngology Coding Alert

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Indispensable Monthly Coding Guide for a Profitable Otolaryngology Practice.

2016 Otolaryngology CPT® Coding Changes

CPT® 2016 introduced only a few new codes related to otolaryngology, but they could be important additions to your coding mix — more specifically one that alters how you report cerumen removal. Of late, this procedure has been a point of interest for otolaryngology coders, especially with the battle over whether you can report 69210 as bilateral with modifier 50.

Post ICD-10 Implementation Challenges

And now that ICD-10 is here, you need to check whether your practice is ready to start reporting ICD-10 codes. The most important thing you need is knowledge of how to use the new otolaryngology codes. For example, you’ll have more codes — and more specific options — for some diagnoses under ICD-10, such as when you report impacted cerumen based on laterality, or tonsillitis based on acute vs. chronic and the infectious agent. But you’ll actually have a simpler time coding other conditions than you do now, such as when your clinician diagnoses acute sinusitis.

Don’t Miss Reimbursements in 2016

2016 fee updates will be easy in some ways because you won’t be dealing with the overwhelming conversion factor cuts of the past. But some other changes in the 2016 Final Medicare Physician Fee Schedule could have serious impact on your bottom-line, thanks to a revamp of relative value unit (RVU) valuations.

Get to Know New E/M Choices in 2016

You already know that for otolaryngology, CPT® 2016 has added new and revised codes such as 92537 (Caloric vestibular test with recording, bilateral; bithermal [i.e., one warm and one cool irrigation in each ear for a total of four irrigations]) and 0406T (Nasal endoscopy, surgical, ethmoid sinus, placement of drug eluting implant). But don’t miss two additions to the E/M section that could come in handy for your physician!

Keeping up-to-date with all these changes is critical for a profitable and compliant otolaryngology practice.

That’s why you should keep yourself current with Otolaryngology Coding Alert, our monthly newsletter written by certified medical coding expert Leigh DeLozier, CPC®, and reviewed by industry expert Barbara J. Cobuzzi, MBA, CPC®, CPC-H, CPC-P, CPC-I, CENTC, CPCO.

Here’s a sample of some topics we’ve covered in recent issues of Otolaryngology Coding Alert:

  • 2016 CPT® updates: Add new endoscopic codes to your mix this year.
  • Remember these 3 points prior to coding scopes with E/M.
  • Know when you can append modifier 62 for co-surgery.
  • Acute pharyngitis in ICD-10: Add the word “unspecified” to J02.9.
  • Simple steps to first-rate tonsillectomy claims.
  • Allergy treatments: Verify that your 95165 claims will pass this carrier’s closer scrutiny.
  • CPT® 2016: Learn these new E/M choices 99415 and 99416.
  • ICD-10: Find a broader descriptor for acute laryngitis.
  • Stick to integumentary codes for wart removal from buccal sulcus.
  • Choose the correct dysphagia code based on swallowing phase.
  • Heed these 3 scenarios to code separate ear tube removal correctly.
  • Successful endoscopic surgery claims start with these 8 tips.
  • Add modifier 22 only for extra work, not extra time.
  • Know the RVU differences for FESS procedures.
  • Ensure you’re handling specialist payment arrangements correctly with these 5 tips.


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