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Topic: Break the chain of common coding errors for ENT procedures, part 2

Ambulatory Surgery Reimbursement Update, April 8, 2008

In last week's issue we discussed the importance of ear, nose, and throat (ENT) procedures as a revenue generator for ASCs. Understanding these procedures is critical to coding them correctly, so ASRU expert Joanne Schade-Boyce, RDH, MS, CPC, ACS, PCS, vice president at FairCode Associates, LLC, in Towson, MD, provides further strategies for coding ENT procedures in this week's issue.

"Another strategy to help coders overcome the challenge of ENT coding is to take an anatomy book and surgeons' operative notes and sit down with them," says Schade-Boyce. "Ask the surgeons to walk through their operative notes and show coders where they were in each stage of the operative note." Coders need to possess enough knowledge about procedures and anatomy to recognize when they need to ask surgeons about procedure details.

Effective communication between coders and physicians is essential to achieving correct ENT coding. For example, a surgeon may not know that a separate CPT code exists to correct nasal stenosis, and so describe the procedure as a septoplasty (a revision of the septum). Such misunderstandings can cost hundreds of dollars per procedure.

"The coder and surgeon can work together in educating one another on the nuances involved in the different procedures and the coding distinctions for each of those procedures, to optimize compliance and revenue integrity," Schade-Boyce says.

Editor's note: This topic is from the April 2008 issue of of Ambulatory Surgery Coding & Reimbursement Insider.

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