Otolaryngology is a specialized medical field focused on the ears, nose, and throat (ENT). Hence, otolaryngologists are also called ENT specialists and train in both medicine and surgery.
While this specialty offers a better work-life balance than others, it is still quite demanding. Otolaryngologists spend considerable time on administrative tasks – around 14 hours per week. This, paired with their daily clinical tasks, leaves them with little time to pay special attention to coding updates.
Are you struggling with the same issue? Let’s take a closer look at some of the common ENT CPT codes for 2024 so you can minimize claim denials.
Most Common ENT CPT Codes 2024
Research has found that coding discrepancies can negatively impact your revenue cycle. According to a review of 176 clinic encounters, 60% of Otolaryngology visits were inaccurately billed before feedback.
While we cannot provide real-time updates or feedback, we can offer you a list of this year’s most common ENT CPT codes. Avoid common billing errors by familiarizing yourself with the following codes.
ENT CPT codes for Evaluation & Management (E/M) Services
CPT Codes 99202 to 99205 – New Patient Office Visits
The ENT CPT codes ranging from 99202 to 99205 cover E/M services for new patients. Each code highlights a different level of complexity and decision-making.
| CPT Code | Description |
|---|---|
| 99202 | Specifies a 15-minute E/M service for a new patient. |
| 99203 | Covers a 30-minute office visit where an ENT specialist makes basic medical decisions after evaluating a new patient. |
| 99204 | Defines a 45-minute intermediate E/M analysis. |
| 99205 | Bills an hour-long E/M analysis. It involves an ENT specialist making complex decisions after evaluating a new patient. |
CPT Codes 99212 to 99215 – E/M Services for Established Patients
The ENT CPT codes from 99212 to 99215, on the other hand, specify office visits for evaluating established patients. In simple terms, these codes represent follow-up visits. Each code highlights a specific amount of time an ENT specialist spends assessing and managing a returning patient’s treatment plan.
| CPT Code | Description |
|---|---|
| 99212 | Covers a 10-minute E/M service for an established patient. |
| 99213 | Indicates an E/M visit lasting 20 minutes that requires an ENT specialist to make low-level medical decisions. |
| 99214 | Bills a 30-minute intermediate E/M analysis of an established patient. |
| 99215 | Pertains to a 40-minute-long complex E/M analysis of an established patient. |
ENT CPT codes for Ear Procedures
CPT Code 69210 – Entrapped Wax Removal
This CPT code for ENT falls within removal procedures on the external ear. To put it simply, billers use the 69210 CPT code when an ENT specialist removes wax buildup from a patient’s ear. They perform this non-invasive procedure via vacuum evacuation, forceps, or a curette.
CPT Code 69220 – Cleaning Mastoidectomy Cavity
This ENT CPT code refers to another popular procedure on the external ear. Specifically, coders use the 69220 CPT code for a cleanup service after a mastoidectomy – surgery to remove diseased cells from behind the ear (mastoid air cells). During this procedure, an ENT specialist cleans the cavity after the infected cell removal surgery.
Remember that patients usually require multiple sessions, also known as debridements, so the cavity dries out and heals properly. These cleaning sessions are also important for preventing infections.
CPT Code 69433 – Ear Tube Placement
This CPT code for otolaryngology refers to an incision procedure on the patient’s middle ear. Otolaryngologists use the 69433 CPT code after inserting a ventilating tube via a small incision in the eardrum.
During this procedure, they typically administer anesthesia, either local (injected to the surface) or topical (directly applied to the surface), to provide pain relief. The ear tube is essential for preventing fluid buildup and improving airflow.
ENT CPT codes for Endoscopic Sinus Procedures
CPT Code 31231 – Nasal Endoscopy
This is a popular diagnostic CPT code for ENT. It refers to a nasal endoscopic procedure. Specifically, you can use the 31231 CPT code after inserting a flexible or rigid tube with a tiny camera and light into your patient’s nose.
This procedure allows ENT specialists to examine the structures inside the nasal cavity, either on one or both sides. In short, otolaryngologists use this endoscopic procedure to diagnose and treat issues like blockages, infections, or abnormalities.
CPT Code 31233 – Maxillary Sinus Endoscopy
The 31233 ENT CPT code also refers to a popular sinus endoscopy procedure. During this process, the provider creates a small hole in a specific location near the upper jaw (usually the canine fossa or inferior meatus) to insert a flexible endoscope.
This allows an ENT specialist to access and examine the maxillary sinus – a type of paranasal sinus (two air-filled cavities in the cheek area next to the nose). This minimally invasive procedure allows healthcare providers to diagnose and treat sinus problems.
CPT Code 31237 – Nasal Endoscopy with Biopsy/Polypectomy/Debridement
This ENT CPT code also refers to a nasal endoscopy. However, it is quite different from the 31231 CPT code. The 31237 CPT code applies to nasal or sinus endoscopy with an additional procedure, such as a biopsy, polypectomy (surgical removal of a nasal polyp), or debridement (removal of damaged or dead tissue).
These combined procedures allow ENT specialists to diagnose and treat nasal issues more effectively.
ENT CPT Codes for Audiologic Function Test
CPT Code 92550 – Tympanometry & Reflex Threshold Test
This global service CPT code for ENT bundles two assessments, tympanometry, and acoustic reflex threshold test. Otolaryngologists use tympanometry to evaluate how well the patient’s middle ear works. The test measures the ear’s response to air pressure changes in the canal.
On the other hand, ENT doctors use reflex threshold testing to measure the middle ear’s reflex responses to varying sounds. In technical terms, acoustic reflex threshold assessment evaluates the functionality of the muscles within the middle ear via headphones.
CPT Code 92557 – Comprehensive Hearing Evaluation
The 92557 CPT code for otolaryngology indicates a comprehensive hearing test. During this evaluation, an ENT specialist assesses the patient’s ability to hear different sounds at different volumes. He plays a series of tones to identify the softest sound that the patient can detect.
Moreover, he also tests the patient’s ability to recognize familiar words and asks him to repeat them. This diagnostic assessment allows an ENT specialist to identify hearing problems.
CPT Code 92567 – Tympanometry
If you are looking for a specific code to claim reimbursement for only tympanometry, you can use the 92567 ENT CPT code. This procedure is essential for diagnosing causes of hearing loss, including earwax or fluid buildup, perforated eardrum, tumor in the middle ear, or injury.
ENT CPT Codes for Larynx Procedures
CPT Code 31525 – Laryngoscopy and Tracheoscopy
This otolaryngology CPT Code defines a laryngoscopy to detect issues in the patient’s voice box or windpipe. During this procedure, an otolaryngologist uses a laryngoscope – a thin instrument like a tube with light and a camera – to examine the patient’s larynx.
If necessary, the ENT specialist may also perform tracheoscopy during this session. He may use a tracheoscope – a type of bronchoscope – to evaluate the patient’s windpipe (trachea). Keep in mind that you can only apply CPT code 31525 to diagnostic procedures performed on patients older than 30 days. In simple words, you cannot use it for newborns.
CPT Code 31575 – Diagnostic Laryngoscopy
The 31575 ENT CPT code covers a diagnostic laryngoscopy. During this procedure, an ENT specialist uses a flexible tube with a camera (laryngoscope) to examine the patient’s larynx (voice box) for any abnormalities.
This code may seem quite similar to the 31525 CPT code. However, it differs slightly as it does not specify the age of the patients. Moreover, it always includes tracheoscopy. In short, CPT code 31575 is the general diagnostic laryngoscopy code. It is mainly used to detect conditions that cause voice and throat problems, including swelling and growth.
CPT Code 31579 – Laryngoscopy & Stroboscopy
This CPT code for ENT is also quite similar to the 31575 CPT code. However, it refers to an additional procedure along with laryngoscopy – stroboscopy. Coding experts use this code when ENT specialists use a rigid or flexible tube (laryngoscope) to look at the patient’s voice box (larynx).
They also perform stroboscopy, a technique for examining the vocal cords to detect any vocal disorders. During this procedure, otolaryngologists illuminate the vocal folds to assess their movement.
ENT CPT Codes for Otolaryngologic & Binocular Microscopy Procedures
CPT Code 92504 – Diagnostic Microscopy for Ears or Nose
The 92504 is a diagnostic ENT CPT code. It is usually used when an ENT doctor uses a microscope to examine the patient’s ears. In some cases, coders also use it to bill for nose microscopy. This test allows otolaryngologists to closely examine the internal structures and diagnose abnormalities, infections, or blockages.
Bottom Line
Like many other specialties, coding is the most complicated part of otolaryngology medical billing. The worst part is that its complexity grows with constant updates, varying rules, and documentation requirements. In short, it is not manageable for everyone. However, learning about the most frequently used CPT codes for Otolaryngology can be a great starting point to minimize billing errors.
We have outlined the 15 most common ENT CPT codes based on valuable data from the American Academy of Otolaryngology-Head and Neck Surgery. However, if you don’t have sufficient support or trained staff, it is better to partner with a company that provides professional ENT medical billing services.
