# Endoscopic Transnasal Biopsy of Clival Lesion



## mthieman@entsc.com (Nov 1, 2010)

Hi, everyone.

One of my doctors performed an endosopic transnasal biopsy of a clival lesion.  Any ideas as to what CPT code to use?

Thanks in advance for your help!

Monica


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## blonde01 (Feb 18, 2013)

I wish someone could have answered this question for you.  We had some consultants come in and tell us that we should bill 31299 for the approach and 64999 for the definitive procedure for this.


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## MaryDx (Jun 3, 2013)

Did your consultant note if CPT 64999 could also be used for an endoscopic transnasal clival mass resection and is there a reference?  Thanks!


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## blonde01 (Jun 4, 2013)

MaryDax said:


> Did your consultant note if CPT 64999 could also be used for an endoscopic transnasal clival mass resection and is there a reference?  Thanks!



Yes they did but the only reference that I have is their presentation.  I may have a query from AMA that I sent for the same thing or something similiar but other than that, that's all.  This is still a grey area.  My surgeons have gone to seminars for their society recently and were told that the ENT can bill 31299 for the approach and bill the definitive skull base procedure code for the tumor resection because it has nothing to do with the approach.  We are currently testing the waters with this regarding reimbursement for coding both ways since we keep getting conflicting information.  I wish there were more resources out there.  Have you tried AOA (Association of Otolaryngology Administrators)?  I recently joined as a coder and it was only $99.  It might be helpful for you.  That and lots of research.  lol

http://www.aoanow.org/


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## MaryDx (Jun 4, 2013)

Thank you!  Appreciate your quick reply and the info - and I'm definitely looking into joining the AOA.


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## blonde01 (Jun 4, 2013)

MaryDax said:


> Thank you!  Appreciate your quick reply and the info - and I'm definitely looking into joining the AOA.



No problem!  I know how frustrating it can be to get no response from queries in addition to limited resources.  It's a hard knock life for us subspecialty coders.


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