An ENT practice may run office endoscopy, audiology testing, allergy care, and surgery out of one building. Each has its own billing rules, and audiology carries a separate Medicare benefit. Otology and neurotology add implant coverage criteria on top.
Book a demoHead and neck care spans procedures, diagnostics, and devices. These are the boundaries to map first.
Diagnostic nasal and laryngeal endoscopies are generally zero-day global procedures, so a same-day visit has to be separately identifiable to be paid. Sinus and ear surgery bring longer global periods with bundled follow-up.
Medicare treats hearing and balance testing as diagnostic tests. Since 2023, patients can see an audiologist without an order once every 12 months for certain non-acute hearing tests, billed with the AB modifier, while other tests still need a physician order.
Original Medicare does not cover hearing aids, but it does cover cochlear implants for patients who meet national coverage criteria. Candidacy testing, surgery, and device programming need records that line up with those criteria.
ENT groups often have physicians, audiologists, and a hearing aid dispensary under one roof.
Physicians and audiologists document each test and procedure and approve the codes Taiga drafts. Hearing aid sales and fittings stay with your dispensary.
Physician and audiology claims: eligibility checks, scrubbing, submission, and every denial and appeal, including small-dollar test denials. Patient statements and follow-up come with it.
Allergy testing and immunotherapy, implant devices, and in-office imaging each raise their own supply and billing questions. Settle which of these come into scope before the handoff.
Bring de-identified examples from each service line and your current denial reasons. Leave patient details out of the booking form.
Clarify whether audiologists bill under their own NPIs, how physician orders are captured, and which tests rely on direct access.
List office endoscopies and procedures separately from surgery at a hospital or surgery center, and who submits each claim.
Flag cochlear implant, vestibular testing, and skull base work. These cases need careful documentation and are worth reviewing one by one.
Useful to an independent ENT owner whose audiology, endoscopy, and surgical claims sit with one stretched team, and who wants coding, submission, and appeals managed inside the current EHR.
Hearing aids and fitting exams are patient-paid under Original Medicare, though some Medicare Advantage plans offer hearing benefits with their own rules. This page does not settle coverage or codes for any test, device, or procedure.
For certain non-acute hearing tests, once every 12 months, yes, with the AB modifier. Balance testing and other services still need an order.
No. Original Medicare does not cover hearing aids or fitting exams, though some Medicare Advantage plans offer hearing benefits.
Not under Medicare. Audiologists have their own benefit and bill the services they personally furnish.
Taiga can take over open A/R or run in parallel with your current process while new claims start, about two weeks after onboarding begins.
Share your mix of office procedures, audiology, surgery, and devices. Taiga will tell you what it could take on and how onboarding would work.
System guides show possible billing handoffs, not proven specialty compatibility.