Here are two tips for coding and billing common ENT procedures.
1. Know 2015 CPT code updates. A number of Current Procedural Terminology code set changes for 2015 are expected to impact otolaryngology, according to the American Academy of Otolaryngology – Head and Neck Surgery.
Changes include:
• 43180, a new code for the reporting of Endoscopic Zenker's Diverticulum
• Deletion of Eustachian tube codes 69400, 69401 and 69405
The American Medical Association RVS Update Committee also reviewed the following codes:
• 92541
• 92542
• 92543
• 92544
• 92545
• 10021
• 30903
• 30905
• 31295
• 31296
• 31297
• 41530
• 30300
• 30906
• 40804
• 42809
• 69200
• 69220
• 92511
Each of these codes could be subject to changes in reimbursement. See the American Academy of Otolaryngology – Head and Neck Surgery report for the full code descriptions.
2. Track external benchmarks. External benchmarking can help healthcare leaders understand if they are capturing as much revenue as efficiently as possible. Here are 10 statistics on ENT revenue per case in ambulatory surgery centers, according to VMG Health's 2012 Intellimarker Ambulatory Surgical Center Financial & Operational Benchmarking Study.
West
• Gross charges per case: $8,426
• Net revenue per case: $1,740
Southwest
• Gross charges per case: $8,673
• Net revenue per case: $2,071
Midwest
• Gross charges per case: $7,710
• Net revenue per case: $2,172
Southeast
• Gross charges per case: $6,537
• Net revenue per case: $1,369
Northeast
• Gross charges per case: $7,494
• Net revenue per case: $2,009
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