Medical coding and billing is a vital process required for claims processing and reimbursement. Given the numerous diagnoses and procedures that a healthcare physician can encounter, it is common to see medical coding errors. The biggest reason for this can be attributed to ibnadequate medical documentation and lack of familiarity with the medical terminology involved.
For an ENT practice, the chances of miscoding, or incorrect coding are even higher due to the variety of conditions and procedures involved. Even more so if the practice does not implement ongoing CPT training for their coding team. Incorrect coding can lead to claim denials and even bigger problems, which is why it may be a wise investment to consider outsourcing medical coding to an established service provider. In this article, we look at the conditions that ENT’s treat, the challenges that are faced when coding with the ICD-10, and some of the most commonly used ICD-10 codes for ENT.
What Conditions do ENT’s treat?
ENT specialists, or otolaryngologists, treat various conditions including swallowing and speech, hearing and balance, allergies and sinuses, breathing and sleep issues, and even skin disorders. A general otolaryngologist does not limit themselves to any single portion and is often able to treat all the conditions mentioned above. However, some ENT specialists pursue additional training in any one of the following areas:
Ear – Hearing, and balance are associated with the ear and are vital in conducting everyday activities. An otolaryngologist who specializes in this area treats conditions ranging from hearing loss, ear infection, ear pain, and dizziness.
Nose – ENT specialists specializing in rhinology basically treat allergies that are caused by harmful allergens and dirt that enters the nose. In addition, they are able to provide care to patients suffering from sinusitis, migraines, septum, nasal obstruction, and skull base tumors.
Throat – Disorders that have a knack of affecting the ability to swallow or speak properly are treated by these ENT specialists. Treatment areas include GERD, throat tumors, hoarseness, sore throat, and more.
ENT Medical Coding – ENT ICD 10 Codes
When it comes to medical coding for ENT diagnosis and procedures, the process is fraught with perils and experts acknowledge that it is an intricate task. The complexities with which certified ENT specialty coders are faced necessitate broad experience that includes the specific, sweeping understanding of pertinent medical terminology, related anatomy, and physiology.
In previous years, there have been several areas in the medical field where coding errors have commonly occurred. Coding for ENT is one of those, where it has been found that medical coders are not adept enough at identifying the information from procedural notes or are not well versed in the ENT terminology.
The scenarios, most often, in an ENT practice are complex that require specialized and experienced coders that have the ability to interpret and extract the information required to accurately code a given diagnosis/procedure. Expert coders ensure that the process is properly done so that the actual amount is reimbursed, reduce the risk of denials, and that all is done in a timely manner.
What is the ICD 10?
The ICD-10 is a cataloging and clinical documentation, short for International Classification of Diseases, 10th edition. The ICD-10 is owned and maintained by the World Health Organization, consisting of thousands of codes representing critical information about the different diseases, causes of injuries, findings, symptoms, and more. The ICD-10 plays an important role in enabling advancements in clinical treatment and medication.
Under the Health Insurance Portability and Accountability Act (HIPAA), it is required by all healthcare providers and physicians to apply the ICD-10 codes in their practices, replacing the previous ICD-9 code set.
ICD serves as a foundation to identify clinical trends and statistics globally. Diseases, injuries, disorders, and all health conditions are listed comprehensively and organized into standard groupings allowing health care providers from around the world to compare and share information using the ICD codes.
Most common ICD 10 Codes for ENT
The table below lists down some of the most commonly used ICD-10 codes for ENT. For a complete and comprehensive list of the ICD-10 codes pertaining to otolaryngology, you can visit the CDC website.
|J30.1||Allergic rhinitis due to pollen|
|H90.3||Sensorineural hearing loss, bilateral|
|J34.2||Deviated nasal septum|
|J30.9||Allergic rhinitis, unspecified|
|H61.23||Impacted cerumen, bilateral|
|K21.9||Gastroesophageal reflux disease without esophagitis|
|J34.3||Hypertrophy of nasal turbinates|
|J32.9||Chronic sinusitis, unspecified|
|H69.80||Other specified disorders of Eustachian tube, unspecified ear|
|H61.20||Impacted cerumen, unspecified ear|
|L82.1||Other seborrheic keratosis|
|D22.5||Melanocytic nevi of trunk|
|J34.89||Other specified disorders of the nose and nasal sinuses|
|H69.83||Other specified disorders of Eustachian tube, bilateral|
|R42||Dizziness and giddiness|
|H93.19||Tinnitus, unspecified ear|
|D48.5||Neoplasm of uncertain behavior of skin|
|J32.0||Chronic maxillary sinusitis|
|L81.4||Other melanin hyperpigmentation|
|J30.2||Another seasonal allergic rhinitis|
As an otolaryngologist, running your practice as well as maintaining the documentation and coding for the reimbursement process can be a huge challenge. control Billing provides efficient ENT and all other medical coding services that can help give you an edge over your competitors as well as making the whole process streamlined.
Getting familiar with the ICD 10 codes, choosing the right codes for diagnosing, and then coding correctly is important for appropriate and prompt reimbursement. At control Billing, our coding specialists have vast experience when it comes to medical billing and coding, ensuring accurate coding for all ENT procedures and services.
check out to UControl Medical today and sit back while we join hands with your organization in giving you that competitive edge you were looking for!