October 09, 2015
ICD-10 and ENT billing
The deadline has passed and although the start was a smooth one, many practices are scrambling to make sure they are ready for bigger times which indicate the stints of the first submission. The overwhelming part about this transition is the large number of new codes and the accuracy that will have to be maintained along with the intricate detailing.
It is only next month which will show the number of denials, that the impact will be really visible. So it is imperative now to ensure precise and error free billing in order to reduce the number of denials in the following month.
ENT practitioners have to perform essential surgical procedures on the same day, in which case it is required to use the apt modifiers and correctly bundled codes in order to secure the billing claims. Using the modifier 50 incorrectly may result with errors in claims, especially when handling the billing for bilateral procedures. Claim denials pertaining to Septoplasty (CPT code 30520) requires appeals and calls for extra documentation. To top it all, intrinsically thorough, expanded audits have only added to the complexity of the problem. ENT practitioners need to ensure strategies to deal with rejections and denials.
Following is a list of some of the new codes that will helpful in gauging the effect of ENT billing and coding:
Oscillating tracking test, with recording
92541: Spontaneous nystagmus test, including gaze and fixation nystagmus, with recording
92542: Positional nystagmus test, minimum of 4 positions, with recording
92543: Caloric vestibular test, each irrigation (binaural, bithermal stimulation constitutes 4 tests), with recording
92544: Optokinetic nystagmus test, bidirectional, foveal or peripheral stimulation, with recording
Thus, the road ahead will require a lot of streamlining of processes and only after the first set of submission of claims, will you be able to gauge your preparedness and direct you accordingly for the next steps to take to avoid any losses of revenue.