CPT for ENT: Modification to NCCI Edit for CPT 69424
December 1, 2023You Asked, We Delivered: Academy Achieves Modification to NCCI Edit for CPT 69424 In early 2013, the Academy was approached by several members and coding experts regarding frequent denials by Medicare Administrative Contractors (MACs) for claims which listed CPT 69424 Ventilating tube removal requiring general…
CPT for ENT: Drainage and Irrigation of the Masseteric Spaces
December 1, 2023Q: What are appropriate codes to report the drainage and irrigation of the masseteric, submandibular, sublingual, and submental spaces when a single incision is made? A: You should report this procedure with CPT code 41018-Extraoral incision and drainage of abscess, cyst, or hematoma of…
CPT for ENT: Neck Dissection and Laryngoscopy on the Same Date of Service
December 1, 2023As a result of the advocacy of the Academy, the National Correct Coding Initiative (NCCI) will delete the current bundling edit for the neck dissection CPT codes (38720-Cervical lymphadenectomy (complete) and 38724 – Cervical lymphadenectomy (modified radical neck dissection) when performed on the same patient…
CPT for ENT: Operating Microscope
December 1, 2023Q: Can I bill for use of the operating microscope, Code 69990? A: Yes. Otolaryngologists commonly use the operating microscope while performing a variety of microsurgical procedures. CPT +69990, Use of operating microscope (list separately in addition to code for primary procedure), is a billable…
CPT for ENT: Modifier 59 Scrutinized
November 30, 2023The CPT Manual defines modifier 59 as follows: “Distinct Procedural Service: Under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-E/M services performed on the same day. Modifier 59 is used to…
CPT for ENT: Utilizing Unlisted CPT Codes
November 30, 2023Q: When should I use an unlisted code? A: An unlisted code should be used to report a procedure when no Category I or III CPT code exists to describe the procedure. Q: When shouldn’t I use an unlisted code? A: When a valid…
CPT for ENT: Intradermal Dilutional Testing
November 30, 2023Q. Should physicians report CPT code 95027 by antigen or per dilution (test or stick)? A. The change for the code descriptor for CPT code 95027 was documented in the American Medical Association’s CPT® Changes for 2003: An Insider’s View. Formerly describing…
CPT for ENT: Lagophthalmos Correction & Gold Eye Weight Placement
November 17, 2023Q: What is gold weight placement in the upper eyelid, and how would I code that procedure? A: It is common for patients diagnosed with lagophthalmos to have a gold weight implanted in the upper eyelid. Lagophthalmos is the inability to fully close the upper…
CPT for ENT: Bundling Issue – Uvulopalatopharyngoplasty and Tonsillectomy
November 17, 2023Q: Can a uvuloplastopharyngoplasty (UPPP) Current Procedural Terminology (CPT code 42145) and a tonsillectomy (CPT code 42826) be billed at the same surgical session? A: The Practice Management Department has noticed an increase in inquiries on the bundling of Tonsillectomy and uvuloplastopharyngoplasty. Historically speaking, the…
CPT for ENT: Lingual Tonsillectomy (CPT 42870) and Adenoidectomy
November 17, 2023Q: Can I report CPT 42870 Excision or destruction lingual tonsil, any method and the codes for adenoidectomy, CPT 42830, 42831, 42835, and 42836 on the same date-of-service? Can I report CPT 42870 Excision or destruction lingual tonsil, any method and the codes…
Future Meeting Information
November 15, 2023Future Annual Meeting & OTO EXPOSM Dates and Locations *subject to change* …
AAO-HNS Summary of CY 2024 MPFS Final Rule
November 9, 2023Following the Centers for Medicare & Medicaid Services’ (CMS) release of the CY 2024 Final Rule for the Medicare Physician Fee Schedule (MPFS), which also includes proposals related to the Quality Payment Program (QPP), the AAO-HNS prepared a high-level summary of key proposals impacting…
CMS Releases 2024 HOPPS/ASC Final Rule
November 9, 2023On November 2, the Centers for Medicare & Medicaid Services (CMS) released the calendar year 2024 Hospital Outpatient Prospective Payment System (HOPPS)/Ambulatory Surgery Center (ASC) Payment System final rule. Following are some of the rule’s key provisions impacting Otolaryngology: CMS finalized the decision to…
Reducing Administrative Burden and Improving Patient Access
November 8, 2023Congress must take action to reform existing administrative hurdles that limit access to prompt patient care by passing the Safe Step Act (S. 652/ H.R. 2630) and the Improving Seniors’ Timely Access to Care Act of 2023. The Safe Step Act would create…
AAO-HNS 2023 Workforce and Socioeconomic Survey
November 7, 2023Academy members who are U.S. practicing physicians, retired, fellows, or residents were emailed a reminder to take the Academy-sponsored survey created by the Workforce and Socioeconomic Survey Task Force on Monday, November 6. Please check your inbox for an email from AAO-HNS…
Clinical Practice Guideline Development Tools
November 6, 2023Developing Patient Decision Aids BridgeWiz Development Manuals Clinical Practice Guideline Development Manual - or Podcast Clinical Consensus Statement Development Manual …
Federal Departments Release New Proposed Rule on No Surprises Act IDR Process
November 2, 2023On October 27, 2023, the U.S. Departments of Health and Human Services, Labor, and the Treasury (the Departments) and the Office of Personnel Management released a proposed rule on the No Surprises Act’s federal independent dispute resolution (IDR) process. The first iteration of…
Residents & Fellows-in-Training Humanitarian Travel Grants
October 31, 2023American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) wishes its members to engage in humanitarian efforts. Humanitarians are those who charitably lay down their life for others in need; that is, their professional skills, time, physical efforts, spiritual commitment, and financial resources…
