Search results

  1. M

    Wiki BLUECARD OUT OF STATE FOR NEW YORK PROVIDERS

    On https://www.bcbs.com/bcbs-companies-and-licensees there are 4 BCBS companies listed for New York State, with links to those payer websites. If you know the patient's home plan, such as Anthem BCBS (formerly Empire BCBS) then the site should have the contact info you are looking for. Good luck!
  2. M

    Wiki VA billing for bilateral procedures

    We have several recent bilateral FESS procedures that we first billed to Veterans Administration Community Care Network (Optum/UHC network) using 50 modifier. Claim was rejected. After speaking with VA we were told to send a corrected claim without the 50 modifier which we did and claim...
  3. M

    Wiki TEP exchange

    From a 2019 article from AAPC, there was this statement: “Although it may seem appropriate to code the replacement of the prosthesis as 31611 with modifier 52, there is a concern that the placement of the prosthesis is a very small component of the total CPT® code 31611, while the creation of...
  4. M

    Wiki Otolaryngology

    Have you tried the AAO-HNS resources site? https://www.entnet.org/resources/ It's not specific to pediatric otolaryngology but has a lot of good CPT info as well as clinical information. Good luck!
  5. M

    Wiki Endocopic excisional removal base of tongue mass coding help

    Thank you!
  6. M

    Wiki Endocopic excisional removal base of tongue mass coding help

    Please give me your input on coding for the following procedure. PROCEDURE PERFORMED: Microdirect layngoscopy with excisional removal of 4.5 x 3 cm left base of tongue mass. OPERATIVE PROCEDURE: Patient was placed in supine position. Routine induction carried out. The patient underwent...
  7. M

    Wiki aetna denials on wax removal

    Same with our practice for Aetna commercial as well as Aetna Medicare. Our physicians want each denial appealed, no payer response yet. Is this occurring with Florida practices only? Any practices in other states, please comment on your Aetna denials experience. Thank you.
  8. M

    Wiki In office compounding of nasal rinse antibiotics

    Is your ENT office doing nasal rinse antibiotics compounding? If so, I'd like to hear from you re your experience planning and implementing that process as well as any coding and/or payer issues you may have encountered. Thank you in advance for your responses.
  9. M

    Wiki CPT input

    Thank you, Nichole. I'm going to look into the Coding Clinic you mentioned in your response. Sounds like a great resource.
  10. M

    Wiki 30930 performed in the office

    The 2022 National Physician Fee Schedule Relative Value File January release (from CMS) indicates 30930 isn't appropriate in an office setting. The NON-FAC NA INDICATOR field of this document is where I found that information. Hope this helps.
  11. M

    Wiki CPT input

    Hi, ENT coders. I request your input re how to code this procedure. I think code should be 42826-52 (tonsillectomy, age 12 and over) and the surgeon wants 42842 (radical tonsillectomy). The report states "Operation Performed: Right radical tonsillectomy for cancer removal" as well as "Brief...
  12. M

    Wiki Interpret Sinus CT imaging

    In a message board/group, a colleague of our ENT practice administrator shared that BCBS of MN is now requiring a board-certified radiologist read/interpret sinus CT imaging as a requirement of balloon sinuplasty prior authorization. Our ENTs' do their own interpretations of sinus CT scans...
  13. M

    Wiki Midline thyroid isthmusectomy

    Hello, cpc2007. My physician performed something similar but also included the following text: "On the CT scan, he had a large goiter and this was noticed over the cricoid extending into the upper tracheal rings. Given that it was nodular, it did not appear to be invading the trachea nor...
Top