Otolaryngology Coding Alert Your practical adviser for ethically optimizing coding, payment, and efficiency in otolaryngology practices

The Coding Institute AVOID AUDITS.IMPROVE REIMBURSEMENT.REDUCE DENIALS.INCREASE REVENUE Otolaryngology Coding Alert Your practical adviser for ethically optimizing coding, payment, and efficiency in otolaryngology practices Also Access Your Alert Online at www.supercoder.com January 2014, Vol. 16, No. 1 (Pages 1-8) In this issue SLP Focus Start Reporting HCPCS Codes for Medicare Patient FEESST Services New G codes from CMS give multiple options for evaluations. Clip & Save Keep These G Codes for Speech-Language Pathology Handy Tip: Don t forget to also include a severity/ complexity modifier. p3 p4 CPT 2014 } Follow 3 Steps to Learn the Latest About Endoscopy Changes for 2014 Plus: Watch for closer review of these nasal endoscopy procedures. New codes and additional guidelines will change some of your coding for endoscopy and esophagoscopy in 2014. The changes are enough that otolaryngology scored a session of its own during the AMA s annual CPT and RBRVS Symposium in Chicago Nov. 13-15. Richard W. Waguespack, MD, a member of the CPT Advisory Committee, shared details about extensive changes to the digestive section for 2014. 1. Get Familiar With New Guidelines CPT 2014 Don t Miss These Corrections to CPT Coding Descriptors Get clear on qualified health care professional definition. ICD-10 Nasal Endoscopy Diagnoses Will Have an Easy Transition in October Encourage thorough documentation to ensure you choose the best option. p5 p5 The entire Esophagus/Endoscopy section has been divided into three subsections for 2014: esophagoscopy, esophagogastroduodenoscopy (EGD), and endoscopic retrograde cholangiopancreatography (ERCP). Three new coding guidelines apply specifically to the entire section: Surgical endoscopy always includes diagnostic endoscopy. Control of bleeding that occurs as a result of the endoscopic procedure is not separately reported during the same operative session. Esophagoscopy includes examination from the cricopharyngeus muscle (upper esophageal sphincter) to and including the gastroesophageal junction. It may also include examination of the proximal region of the stomach via retroflexion when performed. You Be the Coder Additional Reporting of 69801 p5 Note: Otolaryngologists don t often perform esophagoscopy, except perhaps a flexible TNE (transnasal flexible esophagoscopy) at times. However, it s always good to be familiar with updates throughout the CPT sections you use most often. Reader Questions Remember That 30117 Is for Singular Lesion Removal p6 2. Prepare to Report New Codes CPT 2014 introduces six new codes for rigid esophagoscopy and two new codes for transnasal flexible esophagoscopy. Billing for Allergy Tests in Outpatient Department Medicare as Secondary Doesn t Change Your Consultation Pay p6 p7 Prior to 2014, you had a group of codes that applied to either rigid or flexible transoral esophagoscopy (43200-43232). Reasoning: The need for distinction between rigid and flexible esophagoscopy lies in the fact that different means of sedation are used for each and the physician 2014 Call us: 1-800-508-2582 The Coding Institute LLC, 2222 Sedwick Drive, Durham, NC 27713

The Coding Institute SPECIALTY ALERTS Call us: 1-800-508-2582 The Coding Institute LLC, 2222 Sedwick Drive, Durham, NC 27713 Editorial Advisory Board Jean Acevedo, LHRM, CPC, CHC, CENTC President, Acevedo Consulting, Fla. Paul J. Carniol, MD, FACS Clinical Associate Professor University of Medicine & Dentistry of New Jersey Richard A. Chole, MD, PhD Professor and Head, Department of Otolaryngology Washington University School of Medicine, Mo. Barbara J. Cobuzzi, MBA, CPC-OTO, CPC-H, CPC-P, CPC-I, CHCC President, CRN Healthcare Solutions, Tinton Falls, N.J. Senior Coder and Auditor, The Coding Network Margaret M. Hickey, MS, MSN, RN, OCN, CORLN Consultant, New Orleans Jay B. Horowitz, MD, FACS Clinical Associate Professor of Surgery/Otolaryngology Robert Wood Johnson Medical School, N.J. Charles F. Koopmann, MD, MHSA Professor and Associate Chair Department of Otolaryngology Physician Billing Director, Faculty Group Practice University of Michigan, Ann Arbor Janet McDiarmid, CMM, CPC, MPC Past President, American Academy of Professional Coders, National Advisory Board Ron Nelson, PA-C Clinical Practitioner Reimbursement Policy Analyst President, Health Services Associates, Mich. Past President, American Academy of Physician Assistants James N. Palmer, MD Assistant Professor in the Division of Rhinology Department of Otorhinolaryngology: Head and Neck Surgery University of Pennsylvania, Philadelphia James S. Reilly, MD Past President, American Society of Pediatric Otolaryngology Chairman, Department of Surgery and Chief of Otolaryngology, DuPont Hospital for Children, Delaware Professor of Pediatrics and Otolaryngology/Head and Neck Jefferson Medical College, Philadelphia Michael Setzen, MD, FACS, FAAP Clinical Associate Professor in Otolaryngology, NYU School of Medicine Section Chief of Rhinology at North Shore University Hospital; Manhasset, N.Y. Teresa M. Thompson, CPC, CCC ENT Coding Specialist TM Consulting, Wash. Susan L. Turney, MD, FACP Medical Director Reimbursement Marshfield Clinic, Wis. Theodore A. Watson, MD, AAOA, AOA, AON, FACS President; Piedmont ENT, Pa. Steven C. White, PhD, CCC-A Director of Health Care Economics and Advocacy American Speech Hearing Association Rockville, Md. work including risk is different, Waguespack shared at the Symposium. For example: Transoral rigid esophagoscopies are typically performed under general anesthesia. Transoral flexible normally are performed under moderate sedation. Transnasal flexible procedures typically use topical anesthesia. Transnasal flexible esogophogospies are often performed in the office. The new codes for rigid esophagoscopy are: 43191 Esophagoscopy, rigid, transoral; diagnostic, including collection of specimen(s) by brushing or washing when performed (separate procedure) 43192 with directed submucosal injection(s), any substance 43193 with biopsy, single or multiple 43194 with removal of foreign body 43195 with balloon dilation (less than 30 mm diameter) 43196 with insertion of guide wire followed by dilation over guide wire. Pay attention: Each new code also includes parenthetical notes to help you report the service correctly. Watch for differences between these, such as reporting 74235 (Removal of foreign body(s), esophageal, with use of balloon catheter, radiological supervision and interpretation) for radiological supervision and interpretation in conjunction with 43194 but 74360 (Intraluminal dilation of strictures and/or obstructions [e.g., esophagus], radiological supervision and interpretation) for supervision and interpretation with 43196. Transnasal flexible esophagoscopy (TNE) earned two new codes because the work involved in performing TNE differs from the transoral rigid or flexible approaches. The two new codes for 2014 are: 43197 Esophagoscopy, flexible, transnasal; diagnostic, includes collection of specimen(s) by brushing or washing when performed (separate procedure) 43198 with biopsy, single or multiple. Parenthetical instructions list numerous codes you should not submit with either 43197 or 43198. You re also directed to a different code family when reporting transoral esophagoscopy with biopsy or collection of specimen. 3. Watch Your Details for Nasal Sinus Endoscopy Waguspack shared that code 31237 (Nasal/sinus endoscopy, surgical; with biopsy, polypectomy or debridement [separate procedure]) was identified through the CMS High Expenditure Procedural Codes screen. The RUC has Otolaryngology Coding Alert (USPS 019-034) (ISSN 1526-064X for print; ISSN 1947-6825 for online) is published monthly 12 times per year by The Coding Institute LLC, 2222 Sedwick Drive, Durham, NC 27713. 2013 The Coding Institute. All rights reserved. Subscription price is $299. Periodicals postage is paid at Durham, NC 27705 and additional entry offices. POSTMASTER: Send address changes to Otolaryngology Coding Alert, 4449 Easton Way, 2nd Floor, Columbus, OH, 43219 p2

Call us: 1-800-508-2582 The Coding Institute LLC, 2222 Sedwick Drive, Durham, NC 27713 The Coding Institute SPECIALTY ALERTS recommended a survey of physician work and review of practice expense for this code group of services. The group being studied includes 31237 as well as: 31238 with control of nasal hemorrhage 31239 with dacryocystorhinostomy 31240 with concha bullosa resection. Background: Surgeons perform follow-up debridement (31237) after virtually every endoscopic sinus surgery case. Patients typically have about three debridement sessions, but no official guidelines outlining a standard number of treatments exist. Placing 31237 on a watch list means that surgeons should become more conscientious of how often they re performing and billing for the service post-surgery. q SLP Focus } Start Reporting HCPCS Codes for Medicare Patient FEESST Services New G codes from CMS give multiple options for evaluations. If you ve been seeing denials for FEESST (flexible endoscopic evaluation of swallowing with sensory testing) claims, it could be because you re reporting the wrong codes. Read on to be sure you re on board with the latest changes. Look to HCPCS, Not CPT, for Codes In the past, you would report FEESST with either 92610 (Evaluation of oral and pharyngeal swallowing function) or 92614 (Flexible fiberoptic endoscopic evaluation, laryngeal sensory testing by cine or video recording). That began to change when Medicare introduced new FEESST codes in January 2013 with a six-month testing period. The switch: The new codes that Medicare wants reported for FEESST are G codes found in HCPCS instead of CPT. If you file a Part B claim for service on July 1, 2013, or after without the new G codes, Medicare will return the claim unpaid. (See the chart on page XX for a rundown of the G code choices.) Think ahead: If a patient could potentially transition from Medicare Part A to Medicare Part B billing or if the patient has Medicare Part B as a secondary insurance include the appropriate G code and severity modifiers in the patient s medical record. Noting these factors with every evaluation and every tenth treatment day will keep you consistent with Medicare guidelines and will allow for correct reporting if you ever bill Medicare Part B for the services. Pair Codes With the Correct Severity Modifier Each G code you list on the claim must be paired with a modifier indicating the severity or complexity of the patient s condition (on a 7-point scale). These modifiers include: CH (0 percent impaired, limited or restricted), level 7 CI (At least 1 percent but less than 20 percent impaired, limited or restricted), level 6 CJ (At least 20 percent but less than 40 percent impaired, limited or restricted), level 5 CK (At least 40 percent but less than 60 percent impaired, limited or restricted), level 4 CL (At least 40 percent but less than 60 percent impaired, limited or restricted), level 3 CM (At least 80 percent but less than 100 percent impaired, limited or restricted), level 2 CN (100 percent impaired, limited or restricted), level 1. Watch Whether You re Required to Comply Anyone providing therapy (including speech-language evaluation and treatment services) for Medicare Part B beneficiaries must report outcomes on the claim form as part of Medicare s mandatory data collection program. This includes Part B services in: hospitals critical access hospitals private practices skilled nursing facilities home health or rehabilitation agencies outpatient rehabilitation facilities (ORFs) comprehensive outpatient rehabilitation facilities (CORFs). Reporting requirements do not apply to Medicare Part A, Medicare Advantage/HMO plans, Medicaid, or private health plans. q p3

The Coding Institute SPECIALTY ALERTS Call us: 1-800-508-2582 The Coding Institute LLC, 2222 Sedwick Drive, Durham, NC 27713 Clip & Save } Keep These G Codes for Speech-Language Pathology Handy Tip: Don t forget to also include a severity/complexity modifier. The G codes that CMS expects you to report for FEESST are divided into different functions/activities and the patient s therapy status. Keep this chart handy for everyday reference, and watch for more how-to guidance in future issues of Otolaryngology Coding Alert. G-Codes Functional Limitation & Status Swallowing G8996 Swallowing functional limitation, current status at time of initial therapy treatment/episode outset and reporting intervals G8997 Swallowing functional limitation, projected goal status, at initial therapy treatment/outset and at discharge from therapy G8998 Swallowing functional limitation, discharge status, at discharge from therapy/end of reporting on limitation Motor Speech (Note: The codes for Motor Speech are not sequentially numbered) G8999 Motor speech functional limitation, current status at time of initial therapy treatment/episode outset and reporting intervals G9186 Motor speech functional limitation, projected goal status at initial therapy treatment/outset and at discharge from therapy G9158 Motor speech functional limitation, discharge status at discharge from therapy/end of reporting on limitation Spoken Language Comprehension G9159 Spoken language comprehension functional limitation, current status at time of initial therapy treatment/episode outset and reporting intervals G9160 Spoken language comprehension functional limitation, projected goal status at initial therapy treatment/outset and at discharge from therapy G9161 Spoken language comprehension functional limitation, discharge status at discharge from therapy/end of reporting on limitation Spoken Language Expression G9162 Spoken language expression functional limitation, current status at time of initial therapy treatment/episode outset and reporting intervals G9163 Spoken language expression functional limitation, projected goal status at initial therapy treatment/outset and at discharge from therapy G9164 Spoken language expression functional limitation, discharge status at discharge from therapy/end of reporting on limitation Attention G9165 Attention functional limitation, current status at time of initial therapy treatment/episode outset and reporting intervals G9166 Attention functional limitation, projected goal status at initial therapy treatment/outset and at discharge from therapy G9167 Attention functional limitation, discharge status at discharge from therapy/end of reporting on limitation Memory G9168 Memory functional limitation, current status at time of initial therapy treatment/episode outset and reporting intervals G9169 Memory functional limitation, projected goal status at initial therapy treatment/outset and at discharge from therapy G9170 Memory functional limitation, discharge status at discharge from therapy/end of reporting on limitation Voice G9171 Voice functional limitation, current status at time of initial therapy treatment/episode outset and reporting intervals G9172 Voice functional limitation, projected goal status at initial therapy treatment/outset and at discharge from therapy G9173 Voice functional limitation, discharge status at discharge from therapy/end of reporting on limitation Other SLP Functional Limitation G9174 Other speech language pathology functional limitation, current status at time of initial therapy treatment/episode outset and reporting intervals G9175 Other speech language pathology functional limitation, projected goal status at initial therapy treatment/outset and at discharge from therapy G9176 Other speech language pathology functional limitation, discharge status at discharge from therapy/end of reporting on limitation q p4

Call us: 1-800-508-2582 The Coding Institute LLC, 2222 Sedwick Drive, Durham, NC 27713 The Coding Institute SPECIALTY ALERTS CPT 2014 } Don t Miss These Corrections to CPT Coding Descriptors Get clear on qualified health care professional definition. CPT 2014 has barely hit coders desks, but the American Medical Association (AMA) has already released explanatory notes and corrections. Every coder needs to be clear on what qualified health care professional means, and you might also find some chemodenervation updates of interest. Starting point: Some updates are classified as errata (E) and others as technical corrections (T). An errata shows information that was approved by the CPT Editorial Panel but inadvertently left out of the current CPT book. Technical corrections clarify the Editorial Panel s intent for the current code structure. Let Facilities Count as Health Care Professional CPT 2013 introduced the use of qualified health care professional throughout the book when codes distinguish who is able to provide the service. The introduction to CPT 2014 now includes an important clarification regarding this terminology. Errata posted to the AMA website on Nov. 11, 2013, stated, Throughout the CPT code set the use of terms such as physician, qualified health care professional, or individual is not intended to indicate that other entities may not report the service. In selected instances, specific instructions may define a service as limited to ICD-10 } Nasal Endoscopy Diagnoses Will Have an Easy Transition in October Encourage thorough documentation to ensure you choose the best option. professionals or limited to other entities (e.g., hospital or home health agency). Revise the instructions for use of the CPT codebook guidelines to include missing content define a service as limited to professionals or limited to other entities (e.g., hospital or home health agency). Bottom line: If you code for services rendered in a facility setting, you can still report codes that include qualified health care professional in the descriptor, when appropriate. For example, even if a service does not include an NPP in the description, but the service is within the scope of a NPP, such as an admission into the hospital by a nurse practitioner, the NP may provide and code for this service. The NP s NPI must be used for the claim since a NP cannot provide incident to services in an inpatient place of service. Correct Chemodenervation Parenthetical Note Chemodenervation code 64620 (Destruction by neurolytic agent, intercostal nerve) includes three parenthetical notes to clarify the code s use. The first note states that imaging guidance (including fluoroscopy or CT) is included in certain chemodenervation codes. Correction: Mark in your CPT book that the applicable code range should be 64633-64636 because the original version included transposed codes. q When your otolaryngologist performs a surgical nasal or sinus endoscopy with biopsy / debridement, one code you frequently report is 31237 (Nasal/sinus endoscopy, surgical; with biopsy, polypectomy or debridement [separate procedure]). Many diagnoses related to nasal polyps, neoplasms, or other conditions can help justify the procedure. Fortunately, most of the supporting diagnoses will be simple to find when ICD-10 becomes effective in October 2014 because their descriptors will remain the same. Consider these examples: (Continued on next page) You Be the Coder Additional Reporting of 69801 Question: My physician wants to bill 69801 with modifier 58 two weeks after the original procedure. I believe the 90-day global period associated with 69801 was eliminated recently, but am not sure. Can you please shed some light on this? Montana Subscriber Answer: See page 7. q p5

The Coding Institute SPECIALTY ALERTS Call us: 1-800-508-2582 The Coding Institute LLC, 2222 Sedwick Drive, Durham, NC 27713 471.0 (Polyp of nasal cavity) will become J33.0 (Polyp of nasal cavity) 147.0 (Malignant neoplasm of superior wall of nasopharynx) will shift to C11.0 (Malignant neoplasm of superior wall of nasopharynx) 210.7 (Benign neoplasm of nasopharynx) will be reported as D10.6 (Benign neoplasm of nasopharynx). Watch point: Some diagnosis codes supporting 31237, however, will expand to become more specific. For Reader Questions } Remember That 30117 Is for Singular Lesion Removal Question: One of our surgeons needs to excise two intranasal lesions and wants to know if he can bill for both. He wants to use CPT code 30117 and then 30117 again with a modifier 59. Is this reasonable to bill this procedure like this? North Carolina Subscriber Answer: Code 30117 (Excision or destruction [e.g., laser], intranasal lesion; internal approach) represents intranasal lesion excision or destruction. The lesion can be anywhere on the inner nose, not just on the right or left side. The descriptor also specifies lesion as singular, not plural. This means you should report multiple units or append modifier 59 (Distinct procedural service) if the otolaryngologist removes lesions from different sites. Check with the payer to verify which reporting tactic they prefer. q Billing for Allergy Tests in Outpatient Department Question: Our ENT completed allergy testing for a patient in the outpatient clinic, which is located in the hospital s emergency department. The physician is employed by the hospital and his clinic is also hospital-owned. Can he bill for the allergy testing? Oregon Subscriber Answer: Whether your physician can bill for the testing depends on the situation. Outpatient facility allergy services are covered under APCs (ambulatory payment classifications). If this is example, you currently report 461.1 for acute frontal sinusitis. ICD-10 will give you two options based on whether you know if the patient s sinusitis is recurrent: J01.10 (Acute frontal sinusitis, unspecified) and J01.11 (Acute recurrent frontal sinusitis). Coding tip: As with any diagnosis, having more details in your physician s documentation is the first step toward selecting the most accurate codes supporting his services. q a hospital-based outpatient clinic, then you can report the service. An employee of the hospital (including the physician, if that s the case) can administer the test and the hospital can bill it under the APC. If you re coding for a physician practice owned by the hospital, however, the test may or may not be billable. The physician can administer and bill for the service, but his nurse cannot administer the test and bill it as incidentto the physician for services provided in a hospital outpatient facility. q SPEcialty-SPEcific icd-10 webinars by industry experts AudioEducator provides the most economical and effective audio sessions on ICD-10. From the comfort of your office or home, learn what you need to navigate the new codes and master documentation requirements. And you can get answers to your top questions during the Q&A at the end of the session. Log on to www.audioeducator.com/icd-10 and check out our upcoming and on-demand webinars for your specialty. You can also buy CD recordings and PDF transcripts. Call 1-866-458-2965 or email to customerservice@audioeducator.com for help! 2222 Sedwick Drive, Durham, NC 27713 Contact Us: 1-866-458-2965 p6

Call us: 1-800-508-2582 The Coding Institute LLC, 2222 Sedwick Drive, Durham, NC 27713 The Coding Institute SPECIALTY ALERTS Medicare as Secondary Doesn t Change Your Consultation Pay Question: I know Medicare doesn t reimburse consults anymore, but a new coder we hired said that at her old practice, she continued to get paid for consults if the primary payer accepted them and Medicare was secondary. She said as the secondary payer, Medicare will pay consultations. Can you direct us to the regulations on this? Arizona Subscriber Answer: It s true that the primary payer if it s a non-medicare insurer may still reimburse you for consultations. However, even if Medicare is secondary, your MAC still won t pay a dime for consults. Medicare will no longer recognize the consultation codes for purposes of determining Medicare secondary payments (MSP), CMS said in MLN Matters article MM6740, which indicates the following: In MSP cases, physicians and others must bill an appropriate E/M code for the services previously paid You Be the Coder Additional Reporting of 69801 (Question on page 5) Answer: You are correct about the change code 69801 (Labyrinthotomy, with perfusion of vestibuloactive drug[s]; transcanal) now has 0 global days. Background: Prior to 2011, code 69801 had a 90-day global period so all follow-up care during that time frame (including repeat injections in the same ear) was covered by the initial code reporting. Now you can report subsequent injections separately if the physician administers them on different dates. No modifier (including 58, Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period) is needed. Also include: Be sure to report the correct HCPCS code for the drug used during the injection. This will usually be Decadron (J1100, Injection, dexamethasone sodium phosphate, 1 mg) or gentamicin (J1580, Injection, Garamycin, gentamicin, up to 80 mg). ). Remember: Patients who receive gentamicin treatments must remain in the office for at least 15-20 minutes of monitoring after every injection. That is time and money to the practice, which is why 69801 has a relatively high RVU (the total unadjusted non-facility RVU is 5.99). q using the consultation codes. If the primary payer for the service continues to recognize consultation codes, you should bill in one of the following two ways: Bill the primary payer a non-consult E/M code, and then report the amount actually paid by the primary payer, along with the same E/M code, to Medicare for determination of whether a payment is due; or Bill the primary payer using a consult code, and then report the amount actually paid by the primary payer, along with a non-consult E/M code that is appropriate for the service, to Medicare for determination of whether a payment is due. CMS indicates in the MLN Matters article that the first option may be easier from a billing and claims processing perspective. Potential snag: In some cases, such as a physician seeing a hospital patient, the doctor may not know whether the patient is on Medicare or has a different insurer when he documents his consultation. Coders will need to be able to glean an appropriate E/M code from the physician s consult documentation if the patient ends up being on Medicare. Editor s note: To read the MLN Matters article on MSP claims billed after Medicare s 2010 consult elimination, visit www.cms.hhs.gov/mlnmattersarticles/downloads/ MM6740.pdf. q Answers to You Be the Coder and Reader Questions reviewed by Barbara J. Cobuzzi, MBA, CPC, CPC-H, CPC-P, CENTC, CHCC, president of New Jersey-based CRN Healthcare Solutions. We Want to Hear From You Tell us what you think about Otolaryngology Coding Alert. What do you like? What topics would you like to see us cover? What can we improve on? We d love to hear from you. Please email Leigh DeLozier at leighd@codinginstitute.us Thank you in advance for your input! p7

The Coding Institute SPECIALTY ALERTS Call us: 1-800-508-2582 The Coding Institute LLC, 2222 Sedwick Drive, Durham, NC 27713 AVOID AUDITS.IMPROVE REIMBURSEMENT.REDUCE DENIALS.INCREASE REVENUE O to l a r y n g o l o g y C O D I N G A L E R T We would love to hear from you. Please send your comments, questions, tips, cases, and suggestions for articles related to Otolaryngology Coding Alert to the Editor indicated below. Leigh DeLozier leighd@codinginstitute.us Editor Barbara J. Cobuzzi, MBA, CENTC, CPC-H, CPC-P, CPC-I, CHCC Consulting Editor Mary Compton, PhD, CPC maryc@codinginstitute.us Editorial Director and Publisher Jennifer Godreau, CPC, CPMA, CPEDC jenniferg@codinginstitute.com Director of Development & Operations The Coding Institute LLC, 2222 Sedwick Drive, Durham, NC 27713 Tel: 1-800-508-2582 Fax: 1-800-508-2592 E-mail: service@codinginstitute.com Otolaryngology Coding Alert is designed to provide accurate and authoritative information in regard to the subject matter covered. It is sold with the understanding that the publisher is not engaged in rendering legal, accounting, or other professional services. If legal advice or other expert assistance is required, the services of a competent professional should be sought. CPT codes, descriptions, and material only are copyright 2013 American Medical Association. All rights reserved. No fee schedules, basic units, relative value units, or related listings are included in CPT. The AMA assumes no liability for the data contained herein. Applicable FARS/DFARS restrictions apply to government use. Rates: USA: 1 yr. $299. Bulk pricing available upon request. Contact Medallion Specialist Team at medallion@codinginstitute.com. All major credit cards accepted. This publication has the prior approval of the American Academy of Professional Coders for 0.5 Continuing Education Units. Granting of this approval in no way constitutes endorsement by the Academy of the content. To access each issue s CEU quiz, visit Supercoder.com/ceus and then login. To request login information, email password@supercoder.com The CEU is valid for 1 year from issue s month. This publication has been approved for 0.416 continuing education unit(s) for use in fulfilling the continuing education requirements of the American Health Information Management Association (AHIMA). To access each issue s CEU quiz, visit Supercoder.com/ceus and then login. To request login information, email password@supercoder.com. The Coding Institute also publishes the following specialty content both online and in print. Call 1-800-508-2582 for a free sample of any or all of the specialties below: Anesthesia Cardiology Dermatology Emergency Medicine Family Medicine Gastroenterology General Surgery Health Information Compliance ICD-10 Coding Internal Medicine Neurology & Pain Management Neurosurgery Ob-Gyn Oncology & Hematology Ophthalmology Optometry Coding and Billing Orthopedics Part B (Multispecialty) Pathology/Lab Pediatrics Physical Medicine & Rehabilitation Podiatry Practice Management Psychiatry Pulmonology Radiology Rehab Report Urology Call us (800-508-2582) and mention your customer number for a special price, free trial, or just to find out more about SuperCoder the complete online medical coding solution. Order or Renew Your Subscription! Yes! Start/Renew my one-year subscription (12 issues) to Otolaryngology Coding Alert Print & Online - $399 (Special Renewal price for active subscribers - $299 only!) Print only - $299 Online only - $199 Name Title Company Address City, State, ZIP Phone Fax E-mail * Must provide e-mail address if you choose online or both option to receive issue notifications To help us serve you better, please provide all requested information Payment Options Charge my: MasterCard VISA AMEX Discover Card # Exp. Date: / / Signature: Check enclosed (Payable to The Coding Institute) Bill me (please add $15 processing fee for all bill me orders) Otolaryngology Coding Alert The Coding Institute PO Box 933729 Atlanta, GA 31193-3729 Call 1-800-508-2582 Fax 1-800-508-2592 E-mail: service@codinginstitute.com Promo Code: PC3RAA01 Also Access Your Alert Online at www.supercoder.com p8 Specialty specific codesets, tools, and content on one page in SuperCoder.com. Call (866)-228-9252 now for a super deal!