ENT Billing & Coding Solutions
Streamlined billing and expert coding for Otolaryngology services to maximize collections and reduce claim denials.
Our certified coding and billing team handles everything from sinus surgeries to allergy immunotherapy — helping ENT providers reduce A/R days and improve revenue cycle performance.
Schedule a Free ConsultationCPT & ICD-10 Coding for ENT Procedures
Our team codes and bills for sinus surgeries, ear tube insertions, tonsillectomies, audiograms, nasal endoscopy, and allergy testing using accurate CPT and ICD-10 codes — ensuring medical necessity and compliance across all payer types.
Common Surgical Procedures
- Functional Endoscopic Sinus Surgery (FESS) (31254-31288)
- Tonsillectomy & Adenoidectomy (42820-42836)
- Myringotomy with Tube Insertion (69433-69436)
- Septoplasty (30520) & Turbinate Reduction (30130-30140)
Diagnostic Procedures
- Nasal Endoscopy (31231-31235)
- Laryngoscopy (31575-31579)
- Audiometry (92550-92588)
- Tympanometry (92567)
Specialized Billing for Audiology & Allergy
We handle audiology services, vestibular assessments (e.g., VNG), allergy testing (95004, 95024), and immunotherapy billing with dedicated workflows — ensuring accurate HCPCS and CPT coding with proper modifier usage and documentation.
Our Expertise Includes:
Pre-Authorization & Eligibility Checks
We verify patient insurance coverage in advance and obtain prior authorizations for procedures such as CT scans, surgeries, and endoscopies to prevent avoidable denials and patient billing issues.
Our Pre-Auth Process for ENT:
- Identify procedures requiring authorization based on payer-specific policies
- Gather clinical documentation (imaging results, failed medical therapy)
- Submit complete authorization requests with medical necessity justification
- Track approval status and communicate with your office
- Appeal denied authorizations with peer-reviewed literature when needed
Appeals, Denial Management & A/R Follow-Up
Our expert A/R team tracks and appeals denied claims using payer-specific policies, recovers underpayments, and aggressively follows up on aged receivables to improve your practice's cash flow.
Common ENT Denials We Resolve:
- Bundled sinus procedures
- Medical necessity for CT scans
- Allergy testing frequency limits
- Modifier -59 misuse
- Global period violations
Our A/R Recovery Process:
- Daily claim status checks
- Payer-specific appeal strategies
- Underpayment identification
- Patient balance follow-up
- Monthly A/R aging reports
ENT-Specific Modifier Applications
Proper modifier usage is critical for ENT billing. Our certified coders ensure correct application of modifiers to prevent denials and maximize reimbursement.
| Modifier | ENT Usage | Example |
|---|---|---|
| -50 | Bilateral procedure | Bilateral myringotomy tubes |
| -51 | Multiple procedures | Tonsillectomy with adenoidectomy |
| -59 | Distinct procedural service | Nasal endoscopy with biopsy |
| -TC | Technical component | In-office audiometry |
ENT-Specific Billing Technology
Our proprietary billing platform includes ENT-specific features to optimize your revenue cycle:
Audiology Workflow
Specialized templates for hearing tests and device billing
Allergy Tracking
Dose tracking and auto-billing for immunotherapy
Sinus Surgery Analytics
Procedure-specific reimbursement benchmarks
What ENT Practices Say
Dr. Sarah Williamson
Coastal ENT Specialists
"Their understanding of FESS coding and bundling rules increased our collections by 18% in the first quarter. The detailed denial reports helped us identify patterns with certain payers."
Michael T., Practice Administrator
Midwest ENT & Allergy
"The allergy billing specialists recovered $32,000 in underpaid immunotherapy claims we didn't even know we were missing. Their documentation review process is incredibly thorough."
ENT Billing FAQs
How do you handle global periods for common ENT procedures?
We track all ENT surgical global periods (e.g., 90 days for sinus surgeries, 10 days for tonsillectomies) and ensure proper billing of post-op visits. Our system flags any services that may fall within global periods to prevent billing errors.
What's your approach to billing in-office procedures like nasal endoscopy?
We verify documentation supports both the procedure and any separate E/M service, applying modifier -25 when appropriate. Our coders check for required elements like indication, findings, and medical decision making.
How do you stay current with ENT-specific coding changes?
Our team attends AAO-HNS coding courses, reviews CMS transmittals affecting ENT codes, and participates in specialty-specific training. We provide quarterly updates to clients on coding changes impacting ENT practices.