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Audiology billing

Audiology is one of our chosen domains and we have acquired extensive knowledge in Audiology billing over the past 15 years. We have presented in many Audiology conferences on the best practices of Audiology billing and optimized reimbursements. Our ENT and Audiology clients are spread across the united states, and we are well acclimatized to the regulations of each state and its payors.

Audiology billing includes claiming reimbursements for expensive hearing aids, that were bought and disbursed by the ENT clinics and the Audiologists. This is an initial out of pocket expense for the Audiologists, which is reimbursable upon a suitable claim, for entitled patients and plans. Hence stringent benefit verification has to be performed to ensure that the patient and their plan is entitled to receive these Hearing tests, and Hearing aids.

Procedures performed by Audiologists

Procedures performed by Chiropractors

The most critical factor in claiming accurate reimbursement lies in understanding the multiple coding systems that covers various services. A biller should be familiar with ICD-10-CM and ICD-10-PCS coding systems. HCPS level II codes (Healthcare Common Procedure Coding System) are normally referred as National code, which is annually published and maintained by the Centers for Medicare and Medicaid Services (CMS).

Following is the broad classification of codes

Disease of external ear (H60 to H62)
H60 Otitis external
H61 Other disorders of external ear
H62 Disorders of external ear in diseases classified elsewhere
Disease of middle ear and mastoid (H65 to H75)
H65 Non suppurative Otitis media
H66 Suppurative and unspecified Otitis media
H67 Otitis media in diseases classified elsewhere
H68 Eustachian salpingitis and obstruction
H69 Other and unspecified disorders of Eustachian tube
H70 Mastoiditis and related conditions
H72 Perforation of tympanic membrane
H73 Other disorders of tympanic membrane
H74 Other disorders of middle ear mastoid
H75 Other disorders of middle ear and mastoid in diseases classified elsewhere
Diseases of inner ear (H80 to H83)
H80 Otosclerosis
H81 Disorders of vestibular function
H82 Vertiginous syndromes in diseases classified elsewhere
H83 Other diseases of inner ear
Other diseases of ear (H90 to H94)
H90 Conductive and sensorineural hearing loss
H91 Other and unspecified hearing loss
H92 Otalgia
H93 Other disorders of ear, not elsewhere classified
H94 Other disorders of ear in diseases classified elsewhere classified
H95 Intraoperative and postprocedural complications and disorders of ear and mastoid process, not elsewhere classified
Congenital malformations, deformations and chromosomal abnormalities (Q00-Q09)
Q10 – Q18 Congenital malformations of eye, ear, face and neck
Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R99)
R90 – R94 Abnormal findings on diagnostic imaging and in function studies, without diagnosis
Injury, poisoning and certain other consequences of external causes (S00-T88)
S00 – S09 Injuries of the head
S01 Open wound of head
S08 Avulsion and traumatic amputation of a part of head
S09 Other unspecified injuries of head
T07-T88 Injury, poisoning and certain other consequences of external causes
T15-T19 Avulsion and traumatic amputation of a part of head
T36-T50 Poisoning by, adverse effects of and under-dosing of drugs, medicaments and biological substances
T51-T65 Toxic effects of substances chiefly nonmedicinal as to source
T66-T78 Other and unspecified effects of external causes
T79 Certain early complications of trauma
T80-T88 Complications of surgical and medical care, not elsewhere classified
V00-Y99 External causes of morbidity
Persons encountering health services for examinations (Z00-Z13)
Z00 Encounter for general examination without complaint, suspected or reported diagnosis
Z01 Encounter for other special examination without complaint, suspected or reported diagnosis
Z02 Encounter for other special examination without complaint, suspected or reported diagnosis
Z04 Encounter for examination and observation for other reasons
Z05 Encounter for observation and evaluation of newborn for suspected diseases and conditions ruled out
Z13 Encounter for screening for other diseases and disorders
Encounters for other specific health care (Z40-Z53)
Z44 Encounter for fitting and adjustment of external prosthetic device
Z45 Encounter for adjustment and management of implanted device
Z46 Encounter for fitting and adjustment of other devices
Z51 Encounter for other aftercare
Z55-Z65 Persons with potential health hazards related to socioeconomic and psychosocial circumstances
Persons encountering health services in other circumstances (Z69-Z76)
Z71 Persons encountering health services for other counseling and medical advice, not elsewhere classifiable
Z72 Problems related to lifestyle
Z73 Problems related to life management difficulty
Z76 Persons encountering health services in other circumstances
Persons with potential health hazards related to family and personal history and certain conditions influencing health status (Z77-Z99)
Z77 Other contact with and (suspected) exposures hazardous to health
Z81 Family history of mental and behavioral disorders
Z82 Family history of certain disabilities and chronic diseases (leading to disablement)
Z83 Family history of other specific disorders
Z86 Personal history of certain other diseases
Z87 Personal history of other diseases and conditions
Z90 Acquired absence of organs, not elsewhere classified
Z96 Presence of other functional implants
Z97 Presence of other devices
Neoplasms (C00 - D49)
C00 – C14Malignant Neoplasm of lips, oral cavity and pharynx
C15-C26Malignant neoplasms of digestive organs
C30-C39Malignant neoplasms of respiratory and intrathoracic organs
C69-C72Malignant neoplasms of eye, brain and other parts of central nervous system
D00-D09In situ neoplasms
D10-D36Benign neoplasms, except benign neuroendocrine tumors
C00 Malignant Neoplasm of lip
C01 Malignant Neoplasm of base of tongue
C02 Malignant Neoplasm of other and unspecified parts of tongue
C03 Malignant Neoplasm of gum
C04 Malignant Neoplasm of floor of mouth
C05 Malignant Neoplasm of palate
C06 Malignant Neoplasm of other and unspecified parts of mouth
C08 Malignant Neoplasm of other and unspecified parts of salivary glands
C09 Malignant Neoplasm of tonsil
C10 Malignant Neoplasm of oropharynx
C11 Malignant Neoplasm of nasopharynx
C14 Malignant Neoplasm of other and ill-defined sites in the lip, oral cavity and pharynx
C15 Malignant Neoplasm of esophagus
C30 Malignant neoplasms of nasal cavity and middle ear
C32 Malignant neoplasms of larynx
C33 Malignant neoplasms of trachea
C71 Malignant neoplasms brain
D00 Carcinoma in situ of oral cavity, esophagus and stomach
D02 Carcinoma in situ of middle ear and respiratory system
D10 Benign neoplasm of mouth and pharynx
D14 Benign neoplasm of ear and respiratory system
D33 Benign neoplasm of brain and other parts of central nervous system
D38 Benign neoplasm of uncertain behavior of middle ear and respiratory and intrathoracic organs
Mental disorders due to known physiological conditions (F01-F09)
F20-F29 Schizophrenia, schizotypal, delusional, and other non-mood psychotic disorders
F40-F48 Anxiety, dissociative, stress-related, somatoform and other nonpsychotic disorders
F01 Vascular dementia
F02 Dementia in other diseases classified elsewhere
F03 Unspecified dementia
F40 Phobic anxiety disorders
F44 Dissociative and conversion disorders
F45 Somatoform disorders
F50- F59 Behavioral syndromes associated with physiological disturbances and physical factors
F60-F69 Disorders of adult personality and behavior
Intellectual disabilities (F70 – F79)
F70 Mild intellectual disabilities
F71 Moderate intellectual disabilities
F72 Severe intellectual disabilities
F73 Profound intellectual disabilities
F78 Other intellectual disabilities
F79 Unspecified intellectual disabilities
Pervasive and specific developmental disorders (F80-F89)
F80 Specific developmental disorders of speech and language
F81 Specific developmental disorders of scholastic skills
F82 Specific developmental disorders of motor functions
F84 Pervasive developmental disorders
F88 Other disorders of psychological development
F89 Unspecified disorder of psychological development
Behavioral and emotional disorders with onset usually occurring in childhood and adolescence (F90-F98)
F90 Attention-deficit hyperactivity disorders
F94 Disorders of social functioning with onset specific to childhood and adolescence
F98 Other behavioral and emotional disorders with onset usually occurring in childhood and adolescence
Inflammatory diseases of the central nervous system (G00-G09)
G00 Bacterial meningitis, not elsewhere classified
G04 Encephalitis, myelitis and encephalomyelitis
Systemic atrophies primarily affecting the central nervous system (G10-G14)
G10 Huntington's disease, Huntington's chorea, Huntington's dementia
G12 Spinal muscular atrophy and related syndromes
Extrapyramidal and movement disorders (G20-G26)
G20 Parkinson’s disease, Hemiparkinsonism, Idiopathic Parkinsonism or Parkinson's disease, Paralysis agitans, Parkinsonism or Parkinson's disease, NOS Primary Parkinsonism or Parkinson's disease
G21 Secondary parkinsonism
Other degenerative diseases of the nervous system (G30-G32)
G30 Alzheimer’s disease
G31 Other degenerative diseases of nervous system, not elsewhere classified
G35-G37 Demyelinating diseases of the central nervous system
Episodic and paroxysmal disorders (G40-G47)
G40 Epilepsy and recurrent seizures
G45 Transient cerebral ischemic attacks and related syndromes
G40 Vascular syndromes of brain in cerebrovascular diseases
G45 Sleep disorders
G50-G59Nerve, nerve root and plexus disorders
G70-G73Diseases of myoneural junction and muscle
G80-G83Cerebral palsy and other paralytic syndromes
G89-G99Other disorders of the nervous system
Diseases of the circulatory system (I00-I99)
Pulmonary heart disease and diseases of pulmonary circulation (I26-I28)
Other forms of heart disease (I30-I52)
Cerebrovascular diseases (I60-I69)
Diseases of the respiratory system (J00-J99)
Pulmonary heart disease and diseases of pulmonary circulation (I26-I28)
Other forms of heart disease (I30-I52)
Cerebrovascular diseases (I60-I69)
Acute upper respiratory infections (J00-J06)
Influenza and Pneumonia (J09-J18)
Other diseases of upper respiratory tract (J30-J39)
Lung diseases due to external agents (J60-J70)
Diseases of the digestive system (K00-K95)
K00 Disorders of tooth development and eruption
K08 Other disorders of teeth and supporting structures
K13 Other diseases of lip and oral mucosa
K14 Diseases of tongue
K20-K31 Diseases of esophagus, stomach and duodenum
Diseases of the musculoskeletal system and connective tissue (M00-M99)
Dentofacial anomalies [including malocclusion] and other disorders of jaw (M26-M27)
Certain conditions originating in the perinatal period (P00-P96)
Newborn affected by maternal factors and by complications of pregnancy, labor, and delivery (P00-P04)
Other disorders originating in the perinatal period (P90-P96)
Congenital malformations, deformations and chromosomal abnormalities (Q00-Q99)
Congenital malformations of the nervous system (Q00-Q07)
Congenital malformations of eye, ear, face and neck (Q10-Q18)
Congenital malformations of the respiratory system (Q30-Q34)
Cleft lip and cleft palate (Q35-Q37)
Other congenital malformations of the digestive system (Q38-Q45)
Congenital malformations and deformations of the musculoskeletal system (Q65-Q79)
Other congenital malformations (Q80-Q89)
Chromosomal abnormalities, not elsewhere classified (Q90-Q99)
Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R99)
Symptoms and signs involving the circulatory and respiratory systems (R00-R09)
Symptoms and signs involving the digestive system and abdomen (R10-R19)
Symptoms and signs involving the nervous and musculoskeletal systems (R25-R29)
Symptoms and signs involving cognition, perception, emotional state and behavior (R40- R46)
Symptoms and signs involving speech and voice (R47-R49)
General symptoms and signs (R50-R69)
Abnormal findings on diagnostic imaging and in function studies, without diagnosis (R90- R94)
Injury, poisoning and certain other consequences of external causes (S00-T88)
Injuries to the head (S00-S09)
Injury, poisoning and certain other consequences of external causes (T07-T88)
Effects of foreign body entering through natural orifice (T15-T19)
Poisoning by, adverse effects of and underdosing of drugs, medicaments and biological substances (T36-T50)
Toxic effects of substances chiefly nonmedicinal as to source (T51-T65)
Other and unspecified effects of external causes (T66-T78)
Certain early complications of trauma (T79)
Complications of surgical and medical care, not elsewhere classified (T80-T88)
External causes of morbidity (V00-Y99)
Factors Influencing Health Status and Contact with Health Services (Z00-Z99)
Persons encountering health services for examinations (Z00-Z13)
Persons with potential health hazards related to socioeconomic and psychosocial circumstances (Z55-Z65)
Persons encountering health services in other circumstances (Z69-Z76)
Persons with potential health hazards related to family and personal history and certain conditions influencing health status (Z77-Z99)