NE is an essential element of office-based clinical rhinology, including the evaluation of chronic rhinosinusitis. Despite the presence of guidelines, variability exists regarding coding and billing for NE, especially concerning the inclusion of E&M codes and the use of the 25 modifiers. The goal of this survey was to assess the billing patterns for NE among ARS members.

Ninety-three respondents completed the survey with a range of years since completing training, practice type, and completion of a rhinology fellowship. Variable responses for billing patterns for distinct clinical scenarios were noted. Higher scores for billing both E&M and NE for the queried clinical procedures were reported for new patients than established patients and postoperative patients. The inclusion of a septoplasty as part of the surgery impacted billing an E&M code 28% of the time. Practice type and history of performing a fellowship did not significantly influence billing patterns for NE.

Significant variability exists among ARS respondents concerning billing patterns for NE, despite the presence of coding guidelines. Additional teaching of standard coding practices for NE may limit variability among otolaryngologists.