- *New* AMA CPT Assistant: Removal of Impacted Cerumen (69209)
- *New* AMA CPT Assistant Article: Drug-Eluting Sinus Implant (CPT 0406T, 0407T)
- *New* Coding Changes for CY 2016
- Coding Changes for CY 2015
- *New* Top 100 ENT Billed Services for CY 2016 (hospital outpatient and physician office settings)
- Top 100 ENT Billed Services for CY 2015 (hospital outpatient and physician office settings)
Audiology Billing Information
CPT for ENT articles are a collaborative effort between the Academy’s team of CPT Advisors, members of the Physician Payment Policy (3P) workgroup, and health policy staff. Articles are developed to address common coding questions received by the health policy team, as well as to clarify coding changes and correct coding principles for frequently reported ENT procedures.
The CMS National Correct Coding Initiative (NCCI) promotes national correct coding methodologies and reduces improper coding which may result in inappropriate payments of Medicare Part B claims and Medicaid claims. The National Correct Coding Initiative (NCCI) contains two types of edits:
1. NCCI procedure-to-procedure (PTP) edits that define pairs of Healthcare Common Procedure Coding System (HCPCS) / Current Procedural Terminology (CPT) codes that should not be reported together for a variety of reasons. The purpose of the PTP edits is to prevent improper payments when incorrect code combinations are reported.
2. Medically Unlikely Edits (MUEs) define for each HCPCS / CPT code the maximum units of service (UOS) that a provider would report under most circumstances for a single beneficiary on a single date of service.
The Medicare Learning Network® (MLN) Educational Web Guides Documentation Guidelines for Evaluation and Management (E/M) Services offers health care professionals E/M services information and resources. These guides are designed to provide education on evaluation and management services. It includes the following information: medical record documentation, evaluation and management billing and coding considerations. E/M services health care professionals may use either version of the 1995 or 1997 documentation guidelines, not a combination of the two, for a patient encounter.