This year, CPT brought good news for ENT coders. Finally, physicians will get paid for canalith repositioning procedure (CRP) coding after a two-year struggle.
When we look back, CPT 2009 excited ENT coders with new CPT code 95992. However the 2009 Medicare Physician Fee Schedule played spoilsport. CMS assigned the codes ‘B' status or bundled it always, making payment for CRP or the Epley maneuver using the new code impossible to get.
However the fight for payment of CRP came to an end because of the 2011 Medicare Physician Fee Schedule.
Note: If the ENT carries out and documents a medically necessary E/M that's significant and separately identifiable from the CRP, add modifier 25 to the evaluation & management service. What's more, Medicare doesn't allow payment for audiologists performing therapeutic procedures, such as CRP.
2011 CPT dictates you can use the code closet to the documented time. And this advice is nothing new. Your documented time must be equal to or exceed the average time given to bill that level. Your documented time must be equal to or get past the average time provided to bill that level. For a 35 minutes spent on a medically necessary counseling-dominated visit is a 99214, per CPT you could report 99215.
If the ENT carries out and documents a medically necessary E/M that's significant and separately identifiable from the CRP, add modifier 25 to the evaluation & management service. What's more, Medicare doesn't allow payment for audiologists carrying out therapeutic procedures, such as CRP.
Always Medicare has taken the times indicated in CPT's code descriptors to represent minimums. The doctor would opt for the lower code unless the time was greater than or equal to the higher-level code's required time.
So will Medicare change its position? At this juncture, it's not sure.
When we look back, CPT 2009 excited ENT coders with new CPT code 95992. However the 2009 Medicare Physician Fee Schedule played spoilsport. CMS assigned the codes ‘B' status or bundled it always, making payment for CRP or the Epley maneuver using the new code impossible to get.
However the fight for payment of CRP came to an end because of the 2011 Medicare Physician Fee Schedule.
Note: If the ENT carries out and documents a medically necessary E/M that's significant and separately identifiable from the CRP, add modifier 25 to the evaluation & management service. What's more, Medicare doesn't allow payment for audiologists performing therapeutic procedures, such as CRP.
2011 CPT dictates you can use the code closet to the documented time. And this advice is nothing new. Your documented time must be equal to or exceed the average time given to bill that level. Your documented time must be equal to or get past the average time provided to bill that level. For a 35 minutes spent on a medically necessary counseling-dominated visit is a 99214, per CPT you could report 99215.
If the ENT carries out and documents a medically necessary E/M that's significant and separately identifiable from the CRP, add modifier 25 to the evaluation & management service. What's more, Medicare doesn't allow payment for audiologists carrying out therapeutic procedures, such as CRP.
Always Medicare has taken the times indicated in CPT's code descriptors to represent minimums. The doctor would opt for the lower code unless the time was greater than or equal to the higher-level code's required time.
So will Medicare change its position? At this juncture, it's not sure.
