ENT Medical Billing Services

ENT billing is uniquely complex. One wrong sinus surgery modifier, one missed nasal endoscopy code, or one bundled hearing test—and thousands in revenue vanish.

Neo MD fixes that with ENT-certified coders, surgical procedure optimization workflows, and aggressive revenue capture built for otolaryngology complexity.

95-97%

First-Pass Claim

+27%

Avg Revenue Increase

90

Days to Results

Is Your ENT Practice
Bleeding Revenue? (Most Are.)

If you fall behind your revenue goals, it’s time to get our professional consultation about the Revenue Cycle Management process. If any of these are happening, you’re losing $150K–$360K+ annually:

Visible Revenue Bleed

Immediate Impact

Priority: Critical
Audit Code: ENT-901

Nasal Endoscopy Claims Denied

Diagnostic vs surgical procedure documentation gaps

Priority: High
Audit Code: ENT-902

Sinus Surgery Claims Rejected

Sinus count and extent errors in billing

Priority: High
Audit Code: ENT-903

Tympanoplasty Claims Denied

Missing medical necessity for revision procedures

Priority: Critical
Audit Code: ENT-904

Sleep Apnea Surgery Claims Delayed

Prior authorization failures for uvulopalatopharyngoplasty

Priority: High
Audit Code: ENT-905

Audiology Testing Claims Bundled

When hearing tests should've been billed separately

Priority: Medium
Audit Code: ENT-906

Bilateral Procedure Modifier Missing

Not applying modifier 50 on bilateral surgeries

Invisible Losses

According to AAO-HNS and MGMA ENT benchmarking data, practices lose 18%–25% of revenue due to:

Sinus Surgery Coding

Undercounting the sinuses operated

24% underpayment

Nasal Endoscopy with Procedure

Bundling diagnostic endoscopy

$14K-$32K/month

Audiology Component Billing

Not billing TC when equipment is owned

High-dollar loss

Laryngoscopy Complexity

Wrong code for operative vs diagnostic

19% denial rate

Septoplasty with Turbinates

Not billing inferior turbinates separately

Critical miss

Allergy Testing Units

Undercounting percutaneous test units

Systematic loss

Revision Surgery Coding

Missing increased complexity modifiers

Compliance risk

Image Guidance Billing

Not billing 61782/31295 with sinus surgery

Untapped revenue
"You didn't train for 10+ years to fight with insurance companies. But right now, coding errors cost more than an ENT surgeon's salary."
Cumulative Revenue Variance
$360,000+
Per Annum Potential

Why General Medical Billing Companies Fail ENT Practices

ENT billing requires specialty expertise that general billers don’t have.

Sinus counting chaos

Can't accurately count and code sinuses operated

Endoscopy bundling blind spot

Bundle diagnostic with surgical procedures

Audiology component confusion

Don't bill TC when practice owns equipment

Bilateral procedure miss

Don't apply modifier 50 on bilateral surgeries

Turbinate coding errors

Don't bill inferior turbinates with septoplasty

Medical necessity gaps

Can't document revision surgery justification

Allergy testing underbilling

Undercount percutaneous test units

Image guidance blindspot

Miss surgical navigation system billing

Result: 15%–22% denial rates, 45-60 day payment cycles, and constant staff time wasted on resubmissions.

The Neo MD ENT Advantage

ENT-Certified Coding Teams

  • Expert in sinus surgery coding (functional endoscopic sinus surgery)
  • Nasal endoscopy optimization (diagnostic vs surgical)
  • Bilateral procedure modifier mastery (50, RT, LT by CPT code)
  • Hearing test and audiology service coding
  • Allergy testing and immunotherapy billing
  • Head and neck lesion removal and reconstruction

→ 95–97% clean claim rate vs 62–74% industry average

Sinus Surgery Revenue Maximization

We ensure proper billing for:

  • Multiple sinus procedures with correct code combinations
  • Maxillary, frontal, ethmoid, and sphenoid sinus codes
  • Image-guided surgery (61782) when applicable
  • Turbinate reduction procedures (30140, 30801-30802)
  • Septoplasty with or without turbinate reduction
  • Post-operative debridement (31237)

→ $16K–$32K monthly recovery from sinus surgery optimization

Complete Prior Authorization Management

We handle authorizations for:

  • Sinus surgery (FESS procedures)
  • Septoplasty and rhinoplasty
  • Sleep apnea surgery (uvulopalatopharyngoplasty, tongue procedures)
  • Thyroidectomy and parathyroidectomy
  • Head and neck tumor excision
  • Advanced imaging (CT sinus, MRI head and neck)

→ 4.1-day turnaround instead of 9–14 days

Nasal Endoscopy Revenue Capture

We optimize billing for:

  • Diagnostic nasal endoscopy (31231) on office visits
  • Surgical nasal endoscopy (31237-31298)
  • Nasal/sinus endoscopy with biopsy
  • Nasal endoscopy with debridement
  • Proper modifier 25 application with same-day E/M

→ $8K–$18K monthly from nasal endoscopy services

Audiology & Hearing Services

We capture:

  • Comprehensive audiometry (92557)
  • Tympanometry (92550, 92567-92570)
  • Speech audiometry (92555-92556)
  • Auditory brainstem response (ABR) testing (92585-92586)
  • Hearing aid evaluation and fitting
  • Balance testing (92531-92548)

→ $6K–$14K monthly from audiology services

Real-Time Revenue Visibility

  • Daily surgical procedure claim tracking
  • Weekly nasal endoscopy billing monitoring
  • Monthly financial performance by procedure type
  • Quarterly payer policy update reviews

→ Complete transparency

ENT Services We Master

Sinus & Nasal Procedures

Functional endoscopic sinus surgery (FESS) for maxillary, ethmoid, frontal, and sphenoid sinuses with proper code combinations, septoplasty for deviated septum correction, turbinate reduction using radiofrequency or submucous resection techniques, image-guided sinus surgery with navigation systems, balloon sinuplasty procedures, and post-operative debridement with correct global period coding.

Office-Based Procedures

 Diagnostic nasal endoscopy with complete visualization and documentation, nasal endoscopy with biopsy of suspicious lesions, debridement of nasal crusts and granulation tissue, foreign body removal from nose or ear, cerumen removal using irrigation or instrumentation, and nasal cauterization for epistaxis management.

Otology & Hearing Services

Comprehensive audiometry with pure tone air and bone conduction testing, tympanometry and acoustic reflex testing, speech audiometry and word recognition scoring, otoacoustic emissions (OAE) testing for hearing screening, auditory brainstem response (ABR) for neurologic assessment, and balance function testing including ENG and VNG studies.

Head & Neck Surgery

Thyroidectomy including total, subtotal, and lobectomy procedures, parathyroidectomy for hyperparathyroidism, parotidectomy and submandibular gland excision, neck dissection for cancer staging or treatment, laryngoscopy with biopsy or lesion removal, and tonsillectomy and adenoidectomy procedures with proper age-based coding.

Allergy Services

Percutaneous and intradermal allergy testing with correct unit billing, allergen immunotherapy build-up phase with visit coding, allergen immunotherapy maintenance phase, venom immunotherapy for insect sting allergies, allergy injection administration codes, and interpretation and report of allergy testing results.

Sleep & Airway Procedures

Uvulopalatopharyngoplasty (UPPP) for obstructive sleep apnea, tongue base reduction procedures, palatal implant placement, septoplasty and turbinate reduction for nasal obstruction, tonsillectomy for obstructive sleep apnea in children and adults, and sleep study interpretation and management.

Real Results: 4-Physician Endocrinology Group (Texas)

“We were missing nasal endoscopy codes on every office visit. Neo MD fixed our sinus surgery coding, corrected our bilateral modifier errors, and helped us optimize audiology billing. Our revenue is up 31% without adding surgeries.”

— Dr. Jennifer S., Otolaryngologist

Metric Before NEO MD After NEO MD (90 Days)
Denial Rate on Sinus Surgery 30% 3.8%
Annual Revenue Loss $620,000 Recovered
Nasal Endoscopy Billing Never Billed +$16,000 / month
Sinus Surgery Coding Optimization Revenue Leakage +$19,000 / month
Bilateral Modifier Accuracy Applied Incorrectly +$11,000 / month
Audiology Services Billing Consistently Underbilled +$8,000 / month
Total Revenue Impact Missed Revenue $64,000 / month
($768K annually)

Free Download

ENT Denial Prevention Checklist

The exact checklist our coders use for 95%+ clean claims.

Sinus surgery coding matrix (maxillary, ethmoid, frontal, sphenoid combinations)

Nasal endoscopy decision tree (diagnostic 31231 vs surgical 31237-31298)

Bilateral procedure modifier guide (which codes allow 50, which require RT/LT)

Post-operative debridement billing rules (31237 within global period)

Hearing test medical necessity templates (audiometry, tympanometry)

Allergy testing unit calculation worksheet (percutaneous, intradermal)

Modifier 25 requirements for same-day E/M with endoscopy

Tonsillectomy age-based coding guide (42820-42826)

Used by 155+ ENT practices. Worth $2,800. Yours free.

Performance: Neo MD vs Industry Standard

Performance Metric Industry Avg Neo MD
Clean Claim Rate 62–74% 95–97%
Denial Rate 26–38% 3–6%
Nasal Endoscopy Capture 38–56% 96%+
Sinus Surgery Accuracy 58–72% 97%+
Bilateral Modifier Accuracy 64–78% 98%+
Audiology Revenue Capture 52–68% 94%+

Our Process: Revenue Acceleration in 90 Days

Step 1 (Week 1)
Free 90-Day Revenue Diagnostic

We begin with a comprehensive analysis of your last 90 days of billing data, examining every sinus surgery for correct code combinations and sinus documentation, reviewing office visits for missed nasal endoscopy procedures, evaluating bilateral modifier application across all procedures, and assessing audiology service billing accuracy. Our team identifies denial patterns by procedure type and payer, examines post-operative debridement coding within global periods, and reviews medical necessity documentation for hearing tests and allergy services. You receive a detailed report showing exactly where revenue is leaking with specific examples of undercoded surgeries and the dollar amount being lost to each type of coding error or missed service opportunity.

Step 2 (Weeks 2-3)
Seamless Transition

Our implementation team coordinates a smooth transition with zero disruption to your surgical schedule or patient care. We integrate with your EMR and surgical documentation system (whether you're using Epic, Athenahealth, NextGen, eClinicalWorks, or any other platform), verify all payer enrollments and credentialing including ASC and hospital privileges, set up ENT-specific coding protocols with automatic nasal endoscopy prompts on office visits, establish bilateral modifier decision trees by CPT code, and provide comprehensive training to your physicians, surgical staff, and audiologists on documentation requirements for sinus surgery, nasal endoscopy, hearing tests, and allergy services. Most practices have their first clean claims submitted within 10-12 business days.

Step 3 (Days 30-90)
Revenue Acceleration

This is where you see immediate financial impact. Our certified ENT coders begin capturing nasal endoscopy codes on every appropriate office visit, implementing correct sinus surgery code combinations based on specific sinuses treated and approaches used, optimizing bilateral procedure modifier application to maximize reimbursement while maintaining compliance, and ensuring proper audiology service coding with medical necessity documentation. We systematically rework and resubmit old denied claims with corrected coding and enhanced surgical documentation. Within the first 30 days, most practices see noticeable cash flow improvement from nasal endoscopy capture alone, and by day 90, our clients average a 26-31% revenue increase without adding surgical time or performing more procedures.

Step 4 (Ongoing)
Continuous Optimization

 Revenue optimization doesn't stop at 90 days. We provide bi-weekly updates on ENT coding changes and payer policy modifications including sinus surgery bundling edits, conduct monthly surgical coding reviews with your providers to ensure continued documentation accuracy for bilateral procedures and sinus combinations, perform quarterly compliance audits on nasal endoscopy billing and post-operative care coding, and deliver annual CPT code update training specific to otolaryngology and audiology services. As your practice adds new procedures like balloon sinuplasty, in-office procedures, or expanded allergy services, we proactively research coverage policies and implement billing protocols to ensure maximum reimbursement from day one.

Critical Compliance Issues We Handle

ENT practices face unique compliance challenges. We protect you:

Sinus surgery documentation

specific sinuses treated, approach documented

Bilateral procedure modifiers

correct modifier by CPT code, 50 vs RT/LT

Nasal endoscopy medical necessity

separate documentation from E/M visit

Post-operative care coding

debridement within global period rules

Hearing test medical necessity

supporting documentation, frequency limits

Allergy testing unit accuracy

correct number of allergens tested

Modifier 25 compliance

separately identifiable E/M with procedures

Global surgical period rules

what's included, what's separately billable

We keep you compliant, paid, and audit-ready.

Frequently Asked Questions

 10–14 days, zero claim disruption.

Yes. We manage billing for office-based procedures and ASC surgical cases with facility fee coding.

 We ensure proper modifier 25 application and separate documentation for same-day services.

 6–9% of collections, but clients average a 26–31% revenue increase.

Yes. We optimize all audiology services, including diagnostics, hearing aids, and balance testing.

We handle complete allergy service billing, including testing, build-up, and maintenance phases.

Stop Losing $25K–$60K Every Month

Every month you delay is another month of compounded clinical leakage.

Sinus surgeries undercoded

Nasal endoscopy was never billed

Bilateral modifiers applied incorrectly

Post-op debridement missed

Audiology services underbilled

Allergy testing revenue lost

Partner with Neo MD

Operational Performance Protocol

Clean Claims Rate
95–97%
Denials below 4%
60 Days
Revenue up 26–31%
90 Days
Nasal endoscopy capture
96%+
Sinus surgery accuracy
97%+
Audiology revenue
94%+

Bilateral modifiers

98%+

Two Ways to Get Started

Option 1

Free Revenue Analysis

No obligation. No sales pitch. Just data.

We’ll show you:

Option 2

Talk to a Specialist

15-minute consultation. Zero pressure.

We’ll discuss:

Or call us directly:

Monday-Friday, 8 am-5 pm EST

The Cost of Waiting

If you’re an ENT practice collecting $3.6M annually and losing 28% to billing inefficiencies:

$1,008,000

Per year in lost revenue

$5.04 million

Over 5 years

That’s hiring another ENT surgeon, opening your own ASC, investing in advanced surgical equipment like image-guided navigation systems, or expanding into comprehensive allergy and audiology services.

Every month you wait costs you $84,000 you'll never recover.

The question isn’t “Should I switch?”
The question is: “How much more am I willing to lose?”

Neo MD Inc. | ENT Medical Billing Specialists

Trusted by 155+ ENT practices across all 50 states