Choose your specialty from the list below to see how our experts have tackled a wide range of client questions.
Looking for something specific? Utilize our search feature by typing in a key word!
Removing a Nasal Pack
I have looked everywhere and cannot find a CPT code for removing a posterior nasal pack. I found CPT code 30906 for reporting control of a nasal hemorrhage when removing and replacing the pack. Can I report 30906 with Modifier 52 since my doctor is just removing the posterior nasal pack?
Question:
I have looked everywhere and cannot find a CPT code for removing a posterior nasal pack. I found CPT code 30906 for reporting control of a nasal hemorrhage when removing and replacing the pack. Can I report 30906 with Modifier 52 since my doctor is just removing the posterior nasal pack?
Answer:
No, you do not report 30906. There is not a code ore removing a posterior pack unless you are replacing the pack at the same time. If you are only removing a pact then report an E/M CPT code or nasal endoscopy code (31231) whichever is more appropriate.
*This response is based on the best information available as of 07/06/23.
Reshaping of the Internal Nasal Valve Region
My physician has started doing repairs for nasal valve collapse using low energy radiofrequency. We have been using the unlisted code 30999. Another coder told me that is no longer the correct code. Can you help?
Question:
My physician has started doing repairs for nasal valve collapse using low energy radiofrequency. We have been using the unlisted code 30999. Another coder told me that is no longer the correct code. Can you help?
Answer:
There is a new CPT code 30469 for reporting remodeling of the nasal airway using low energy temperature controlled radiofrequency which was previously reported with the unlisted code 30999.
*This response is based on the best information available as of 06/22/23.
Sleep Endoscopy
Can I report a nasal endoscopy with a diagnostic drug induced sleep endoscopy?
Question:
Can I report a nasal endoscopy with a diagnostic drug induced sleep endoscopy?
Answer:
No, when reporting CPT code 42975 for a diagnostic drug induced sleep endoscopy you cannot report a nasal endoscopy 31231 unless it is performed for a separate condition other than sleep disordered breathing and using a separate endoscope.
*This response is based on the best information available as of 06/08/23.
Bone Anchored Hearing Implants
What CPT code would I report for implanting a bone anchoredosseointegratedimplant with a magnetic transcutaneous attachment outside of the mastoid?
Question:
What CPT code would I report for implanting a bone anchoredosseointegratedimplant with a magnetic transcutaneous attachment outside of the mastoid?
Answer:
In 2023 three new CPT were created to report Transcutaneousosseointegratedimplants outside of the mastoid. For the implantation the code to report is 69729, for the replacement of the existing device report 69630 and for the removal of the implant report 69728.
*This response is based on the best information available as of 05/25/23.
E/M Coding Based on Time
When choosing the level of E/M we are confused about the History and Exam. If we choose a level of E/M based on time, does this time count toward total time, or is it only time spent on MDM?
Question:
When choosing the level of E/M we are confused about the History and Exam. If we choose a level of E/M based on time, does this time count toward total time, or is it only time spent on MDM?
Answer:
When choosing a level of E/M based on time, CPT identifies the following activities as those that may contribute to total time on the date of service. As displayed below in bold font, obtaining the history and performing the exam contribute to the total time for code selection. These activities occur on the same day as the actual encounter to contribute to the level of service.
Physician/other qualified health care professional time includes the following activities when performed:
- preparing to see the patient (e.g., review of tests);
- obtaining and/or reviewing separately obtained history;
- performing a medically appropriate examination and/or evaluation;
- counseling and educating the patient/family/ caregiver;
- ordering medications, tests, or procedures;
- referring and communicating with other health care professionals (when not separately reported);
- documenting clinical information in the electronic or other health record;
- independently interpreting results (when not separately reported) and communicating results to the patient/family/caregiver; and
- care coordination (when not separately reported).
source: CPT Assistant April 2022
*This response is based on the best information available as of 05/11/23.
Allergy Injections and E/M on the Same Date
We routinely bill allergy an E/M service when the patient comes in for allergy shots. Is that acceptable? Sometimes we bill 99211 if the nurse gives the injection and sometimes if the PA gives the injection 99212.
Question:
We routinely bill allergy an E/M service when the patient comes in for allergy shots. Is that acceptable? Sometimes we bill 99211 if the nurse gives the injection and sometimes if the PA gives the injection 99212.
Answer:
E/M visits should not be reported with allergy injection services 95115 or 95117 unless the visit represents another separately identifiable service. In that situation, report the E/M service with modifier 25 indicating that the patient’s condition required a significant, separately identifiable visit service above and beyond the allergen immunotherapy service provided. If the only service provided is the allergy injection do not report an E/M service. Good documentation is key when reporting an E/M and allergy injections on the same date.
*This response is based on the best information available as of 04/27/23.