Otolaryngology Coding: Tips And Tricks

By Author: Julia Rose
Total Articles: 89
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Otolaryngology is a branch of medical science that deals with the treatment of diseases of ear, nose and throat. This specialty is often referred as ENT. It's a very competitive specialty and for coders, otolaryngology coding can be confusing in certain scenarios. This specialty seldom ventures beyond the throat, but there are conditions that have might have their root causes in the torso. In such cases Otolaryngologists have to venture into gastroenterologists' domain, for example - gastro-esophageal reflux disease (GERD), which affects the larynx and pharynx.


There are many complex scenarios in otolaryngology coding where you'll feel the need of expert advice. For example, coders often get confused whether or not they can use evaluation and management services with allergen immunotherapy CPT codes. CPT rules say that if identifiable services are provided in addition to allergen immunotherapy, office visit codes can be used. However, when the patient is there to receive only an injection with no significant evaluation and ...
... management services, the service cannot be repeated in addition to allergen immunotherapy codes.


CPT 2009 has added many new codes that can help coders deal with difficult situations, but you must leave no loopholes that your claim gets rejected. Payers need reasonable documentation to affirm that services are consistent with the insurance coverage. Whether it's otolaryngology coding or any other specialty, proper documentation validates:


the site of service

the medical necessity and appropriateness of the diagnostic and/or therapeutic services provided

that services furnished have been accurately reported


As a coder, you need a comprehensive know-how to code the full range of ENT services. Attending training camps or conferences can give a solid understanding of otolaryngology codes and also the modifiers used in different scenarios. Plus, you'll get first-hand knowledge on how experts apply the rules and knowledge to avoid commonly made mistakes.


We also provide medical billing and medical coding audio conferences with premier coding experts, CDs, tapes and transcripts of coding training information by specialty.