SpecialtiesSurgical
How we see ent billing.
Reviewed by the VisMed surgical billing team
An otolaryngologist performs procedures in the office all day: nasal endoscopy, laryngoscopy, cerumen removal, ear tube checks, in-office balloon dilation. Each is billable beside the visit when the visit is separately documented, and each has payer rules on frequency and bundling. Audiology adds a stream with its own codes, supervision rules and hearing aid economics. Allergy adds testing and immunotherapy with unit-based billing.
Surgery brings sinus procedure bundling, which is intricate, and authorization requirements on balloon procedures, septoplasty and sleep surgery with medical-necessity criteria that must be in the note.
VisMed gives ENT practices templates that separate the visit from the procedure, coders who know the endoscopy and sinus bundling rules, a separate workflow for each of the audiology and allergy streams, and an authorization desk for surgery.
Where ent practices lose money
The patterns we find in the aging and denial history before anything else changes.
Same-day visit and endoscopy
The visit is billable with modifier 25 when it is significant and separately documented. Routine pre-scope assessments are not, and over-use is an audit flag, so the line has to be drawn per visit.Sinus surgery bundling
Endoscopic sinus procedures bundle by sinus and side with specific rules on what can be billed together. Errors unbundle and recoup, or omit payable work.Audiology supervision and coding
Audiology codes, supervision rules and who may bill them vary by payer, and hearing aid dispensing sits mostly outside insurance.Balloon and septoplasty authorization
Both require authorization with documented failed medical therapy and imaging findings. Procedures done outside the criteria are denied.Allergy units
Testing counts and immunotherapy preparation units must match the records and stay inside payer limits.
What we do differently for ent
Specialty-matched coders and a denials specialist, working inside your own system.
We give you visit-and-procedure templates
The evaluation and the procedure documented in distinct sections, so modifier 25 is applied where it holds and not where it does not.Our ENT coders apply the bundles
Endoscopy, sinus bundling and balloon coding from the report, with payer-specific edits held in our rules.We run audiology and allergy as their own streams
Each with its own charge capture, supervision rules and unit reconciliation.Our authorization desk prepares surgery
Failed medical therapy, imaging and symptom documentation assembled to the plan’s criteria before surgery is booked.
What we bill
The procedure and code families your account team already works in.
ENT billing, asked and answered.
What a physician-owner in this specialty asks on the first call.
Can we bill a visit with every nasal endoscopy?
No, and payers audit practices that do. The visit is billable with modifier 25 when it is a significant, separately documented evaluation. VisMed’s templates keep the two distinct, and our coder applies the modifier only when the note supports it.
Does VisMed know the sinus surgery bundling rules?
VisMed codes procedures by sinus and side from the operative report with the bundling and payer edits applied, and a second coder reviews them.
Can VisMed bill our audiology department?
VisMed handles audiology codes, supervision and billing-provider rules per payer, and separates hearing aid dispensing into a self-pay or benefit-specific workflow as its own stream.
How does VisMed get balloon procedures authorized?
By documenting failed medical therapy, symptoms and imaging findings to the plan’s policy before the request, and by matching the approval to the procedure at charge entry.
Does VisMed bill sleep surgery?
Yes. Uvulopalatopharyngoplasty, tongue-base procedures and hypoglossal nerve stimulation carry strict criteria, usually a sleep study result, body-mass limits and documented PAP failure. VisMed assembles those before the authorization request so the case is approved rather than denied on review.
Also in surgical
General surgery
Global-period tracking and assistant-at-surgery claims.
Orthopedics
Fracture care, implants and DME.
Neurosurgery
Multi-level procedures and co-surgeon billing.
Vascular surgery
Office-based labs and imaging supervision.
Thoracic surgery
Complex globals and critical-care overlap.
Plastic surgery
Reconstructive vs cosmetic separation.
Oral & maxillofacial surgery
Medical and dental claims on one case.
Ophthalmology
Eye-code vs E/M choice, injections and ASC.
Urology
Lithotripsy, in-office procedures and pathology.
OB/GYN
Global obstetric packages and gyn procedures.
Ambulatory surgery centers
Facility claims, implants and payer-specific groupers.
Anesthesia
Time units, modifiers and medical direction.
All specialties
The full list, in six groups
See where your ent practice is losing money. Free.
Six months of aging and denials, read by people who bill your specialty every day — quantified as monthly leakage with a recovery estimate. Yours to keep.
or write directly hello@vis.med