Specialized billing for ear, nose, and throat practices — otolaryngology procedure coding, allergy testing, audiology, and sinus surgery claims. Serving practices nationwide across the United States.
Get Free Practice Audit Contact UsComprehensive billing coverage for your specialty
Accurate coding for tonsillectomies, sinus surgeries, ear tube placements, septoplasty, turbinate reduction, and all ENT procedures.
Allergy skin testing, RAST testing, and immunotherapy billing with proper dosing and administration codes.
Hearing tests, audiograms, tympanometry, ABR testing, and hearing aid dispensing billed to medical and audiology payers.
ENT denials for medical necessity and bundling are aggressively appealed with supporting clinical documentation.
Managing prior auth for ENT surgeries, CT sinuses, sleep studies, and allergy treatment to prevent denials.
Monthly financial reporting for your ENT practice with payer analysis and revenue optimization recommendations.
Otolaryngology packs an unusual amount of billing complexity into routine office days: diagnostic scopes performed alongside E/M visits, sinus surgeries coded across multiple anatomic areas, strict bilateral rules, and an allergy service line with its own multi-year billing structure. ENT practices that bill like general offices systematically miss what makes the specialty profitable.
Nasal endoscopy, flexible laryngoscopy, and otoscopy under the microscope happen constantly in ENT clinic — usually in the same visit as an evaluation. The E/M bills separately only when documentation shows significant, separately identifiable work beyond the scope decision, with modifier 25. ENT sits high on payer audit lists for exactly this pattern, and the fix is documentation structure, not billing bravado. We keep the E/M-plus-scope revenue you've earned while keeping the pattern defensible — our CO-97 guide shows how we fight the bundling denials that still come.
Functional endoscopic sinus surgery bills per sinus area, per side — maxillary, ethmoid, sphenoid, frontal, each with its own codes and combinations, plus balloon dilation alternatives with different coverage rules. Payers apply multiple-procedure reductions and their own bundling edits across the combinations. Coding straight from the operative note, area by area and side by side, is the difference between full surgical reimbursement and quiet underpayment on every case.
Ears and sinuses come in pairs, so ENT lives inside bilateral billing rules: modifier 50 versus RT/LT lines versus two units — every payer wants it differently, and choosing wrong triggers CO-4 denials or 50% underpayments. Tubes, turbinates, and endoscopies all hit this constantly. We keep a bilateral grid per payer so the format is right the first time.
Allergy is ENT's annuity revenue: skin testing (billed per antigen with counts that must match documentation), then serum preparation and antigen units (95165, with payer-specific rules on how many units a vial supports and how doses are counted), then years of injection visits. The vial-and-unit math is where allergy billing goes wrong — undercounting preparation units leaves serious money unbilled; overcounting is an audit flag. We reconcile antigen units to mixing logs and keep the annuity flowing correctly.
Hearing tests, tympanometry, and vestibular studies carry their own supervision requirements and payer quirks — and hearing aid services split between covered diagnostics and non-covered devices with notice requirements. Practices with in-house audiology need the professional/technical component handled cleanly per payer, or the audiology suite becomes a denial generator instead of a service line.
These are 2026 national Medicare rates from the CMS fee schedule. Your local rate is a little higher or lower, and many commercial contracts are priced as a percentage of Medicare, so this is a useful baseline when you review your own payments.
| Code | Service | Office | Facility or reading only |
|---|---|---|---|
| 31231 | Nasal endoscopy, diagnostic | $193.39 | $54.78 |
| 31575 | Flexible laryngoscopy, diagnostic | $127.26 | $61.12 |
| 69210 | Removal of impacted earwax, one ear | $47.76 | $27.05 |
| 92557 | Hearing test, comprehensive | $35.74 | $25.72 |
| 30520 | Septoplasty | Not paid in office | $613.24 |
| 69436 | Ear tubes under general anesthesia | Not paid in office | $144.63 |
| 99214 | Established patient visit, moderate | $135.61 | $84.50 |
Nasal endoscopy and laryngoscopy have 0-day global periods, so a visit on the same day needs a separate problem and modifier 25.
Free one-week audit. We review a week of your claims, denials and open prior authorizations, and show you where money is being lost.
Free one-week trial. We work your ENT claims for a week, so you can see the process before you sign anything.
Simple pricing. Most practices pay a percentage of what we actually collect, typically 4–7% of net collections. Flat-rate pricing is also available.
Specialties that share ENT’s airway, facial and paediatric caseload and its surgical coding families.
Oral and maxillofacial work crosses the dental/medical boundary in both directions.
Sleep-disordered breathing is co-managed, and sleep study billing has strict coverage criteria on both sides.
Tubes, tonsillectomy and paediatric airway work make children a large share of ENT volume.
Facial reconstruction sits squarely between the two specialties, functional and cosmetic components split.
We bill all of these in house. If your group spans several of them, multi-specialty billing keeps one team across every line — or see the full list of services.
Get a free billing audit and see how much more your otolaryngology practice can collect.
Get Free Practice AuditFree resources: Denial Code Lookup | RVU Calculator | AR Days Calculator | CO-236 — endoscopy bundling edits