■ ENT Medical Coding Notes - Complete Edition
This complete PDF includes both: 1. Full ENT Medical Coding Notes (Detailed Reference) 2. ENT
Pocket Cheat Sheet (1-Page Quick Reference) It provides ICD-10-CM codes, CPT procedure
codes, common modifiers, and essential documentation tips.
■ Full ENT Medical Coding Notes
1. Common ENT Conditions & ICD-10-CM Codes
Otitis Media (Middle Ear Infection) H66.0- (Acute suppurative), H65.2- (Serous), H66.4- (Suppurative chron
Otitis Externa (Outer Ear Infection) H60.3- (Acute diffuse), H60.4- (Chronic), H60.5- (Other)
Hearing Loss H90.0- (Conductive), H90.3- (Sensorineural), H90.6- (Mixed), H91.90 (Unsp
Tonsillitis & Adenoid Disorders J03.9 (Acute tonsillitis), J35.0 (Chronic tonsillitis), J35.2 (Hypertrophy of ade
Sinusitis J01.0 (Acute maxillary), J01.1 (Acute frontal), J32.2 (Chronic ethmoidal), J3
Nasal Disorders J34.2 (Deviated septum), J33.9 (Nasal polyps), J34.89 (Other specified diso
Pharyngitis/Laryngitis J02.9 (Acute pharyngitis), J04.0 (Acute laryngitis), J37.0 (Chronic laryngitis)
Sleep Apnea G47.33 (Obstructive), G47.31 (Primary central), G47.39 (Other)
2. Common ENT Procedures & CPT Codes
Ear Procedures 69210 (Cerumen removal), 69420 (Myringotomy), 69436 (Tympanostom
Nose Procedures 31231 (Endoscopy diagnostic), 31237 (Endoscopy with biopsy), 30520 (Sep
Throat Procedures 42825 (Tonsillectomy <12), 42826 (≥12), 42830 (Adenoidectomy), 42820/42
Sinus Procedures (FESS) 31254/31255 (Ethmoidectomy), 31256 (Maxillary antrostomy), 31287 (Sphe
3. Common Modifiers Used in ENT Coding
-50 Bilateral procedure (both ears, both sides of nose, etc.)
-RT / -LT Right or Left (required for ear, nose, throat laterality)
-59 Distinct procedural service (multiple procedures, separate sites)
-52 Reduced services (procedure performed partially)
-25 Significant, separately identifiable E/M service on same day
4. Coding & Documentation Tips
Laterality Always specify Right, Left, or Bilateral
E/M with Procedures Use -25 modifier when billing office visit and procedure same day
Sinus Coding Each sinus has its own code (frontal, maxillary, ethmoid, sphenoid)
Age-based Codes Tonsillectomy codes differ: <12 years vs ≥12 years
Acute vs Chronic Always document infection type (acute, recurrent, chronic)
Audiology Specify conductive vs sensorineural vs mixed hearing loss
Endoscopy Use correct CPT for diagnostic vs with biopsy vs with surgery
■ ENT Pocket Cheat Sheet (Quick Reference)
ICD-10-CM Codes (Common ENT Conditions)
Otitis Media H66.0- Acute suppurative, H65.2- Serous
Otitis Externa H60.3- Acute diffuse, H60.4- Chronic
Hearing Loss H90.0- Conductive, H90.3- SNHL, H90.6- Mixed
Tonsillitis J03.9 Acute, J35.0 Chronic
Sinusitis J01.0 Acute maxillary, J32.2 Chronic ethmoidal
Nasal Disorders J34.2 Deviated septum, J33.9 Polyps
Pharyngitis/Laryngitis J02.9 Acute pharyngitis, J04.0 Acute laryngitis
Sleep Apnea G47.33 OSA
CPT Codes (Common Procedures)
Ear 69210 Wax removal, 69436 Ear tubes, 69420 Myringotomy
Nose 31231 Endoscopy diag, 31237 w/ biopsy, 30520 Septoplasty
Throat 42825 (<12 T&A), 42826 (≥12), 42830 Adenoidectomy, 31525 Laryngoscopy
Sinus (FESS) 31254/31255 Ethmoidectomy, 31256 Maxillary, 31287 Sphenoid
Modifiers
-50 Bilateral procedure
-RT / -LT Right / Left side
-59 Distinct procedural service
-52 Reduced service
-25 Significant E/M with procedure
Quick Tips
Laterality Always specify RT, LT, Bilateral
E/M + Proc Use -25 for both same day
Sinus Coding Code each sinus separately
Age-specific Tonsillectomy <12 vs ≥12
Infections Document Acute vs Chronic