ENT Billing and Coding: Surviving the Coming ICD-10 Changes

December 17, 2014

billing-and-codingIf you work in account management for an Ear Nose and Throat (ENT) practice, there are some things that you will need to know in order to survive the coming ICD-10 changes that are now planned to take effect on October 1, 2015. Otolaryngology management billing and coding will be affected by these changes, just as it will for every other type of medical billing provider. Understanding the new changes that are coming for ENT billing and coding, as well as completing all of the necessary training and certification that is required to properly implement these changes, will help you to smoothly make the transition.

However, there is another way to make sure that your practice is ready for the ICD-10 changes without having to dedicate hours and hours of staff time to learning the new requirements for ENT billing and coding. Medical billing provider services, such as MD Pro Solutions, can help you take control of your Otolaryngology management billing and coding, even streamlining your day-to-day processing of patient billing, coding, collecting and other areas of your practice’s account management. Many practices, clinics and hospitals are turning to MD Pro Solutions to help them survive the ICD-10 changes.

Understanding the ICD-10 Changes
While most physicians and account management understand that the purpose behind the ICD-10 changes is to improve and streamline the way that ENT billing and coding is done, many are still fighting it every step of the way. Each year, the Centers for Medicare and Medicaid Services (CMS) issues a list of brand new and modified codes that are developed by the Current Procedural Terminology (CPT) editorial panel at the American Medical Association (AMA). These updated CPT codes, as they are known throughout the healthcare industry, also come with a list of new or updated values, which are known as Relative Value Units (RVU) for medical services that were reviewed by the Relative Update Committee (RUC) of the AMA.

Once these lists are released by the AMA, CMS has the option to either accept the recommendations of the RVU for physician work and direct practice expense inputs, or it can choose to assign a different value for the medical procedures that are paid for by Medicare and Medicaid. CMS determines the final value, which is the released publicly in the annual Medicare Physician Fee Schedule (MPFS).

Practices and account management personnel who work specifically with Otolaryngology management billing and coding need to be aware of changes made in the valuation of services that are provided to patients under this specialty. Important changes that have been made to the CPT codes for services related to ENT billing and coding for the upcoming ICD-10 changes in 2015 should be known and understood by every medical billing provider that works in Otolaryngology. MD Pro Solutions specializes in Ear Nose and Throat billing, coding and account management, providing comprehensive services to our clients.

What Are the New Codes in the ICD-10 Changes?
The brand new CPT codes and deleted CPT codes will be officially announced in 2015, however there were also some existing ENT billing and coding that was reviewed by the AMA in 2014 that will be included in the final 2015 update. What this means is that practices and providers who work with Otolaryngology need to be prepared for modified RVUs that are coming in 2015. The latest list of code changes that were submitted in November 2014 are now available to be reviewed by physicians, providers and others working in the healthcare industry before they become final.

Here is a list of some of the proposed changes that will affect ENT billing and coding:

  • 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
  • 92545: Oscillating tracking test, with recording

In addition to these proposed changes, which will affect Otolaryngology management billing and coding, there are fourteen other practice expense inputs that were reviewed by the RUC. For these particular codes, physician work was not discussed or surveyed. Some of these practice expense inputs include 10021 – fine needle aspiration without imaging guidance; 31296 – nasal/sinus endoscopy, surgical with dilation of frontal sinus ostium; 30300 – removal foreign body, intranasal office type procedure; and eleven other codes.

MD Pro Solutions Can Help
The healthcare industry is always growing and changing, but right now it is under scrutiny. The coming ICD-10 changes have been overwhelming for some practices, causing many to turn their ENT billing and coding over to a professional account management program, such as MD Pro Solutions. With over 45 years of experience working in the healthcare industry and particularly with Otolaryngology management billing and coding, MD Pro Solutions can help your practice get through the impending ICD-10 changes and streamline your ENT billing and coding procedures to maximize the earning potential of your practice. Use our online form or give us a call at 508-946-1665 to learn more about our services.