# Help with which code to bill for nasal scope



## Christal (Apr 2, 2018)

I have recently took over billing at the Dr. office I work for. We do nasal scopes with a flex scope. We mainly do the scopes to check the sinus area out but he will go and see the larynx as well. Do I code a 92511 for nasopharyngoscopy, or 31231 for nasal endoscope, or 31575 laryngoscopy? I am confused on this one. I know reimbursement is higher for nasal enoscopy. I also know the purpose of the procedure is to make sure sinus is draining properly and no issues in any of the sinus area. 

Thank you


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## BarkerP (Apr 3, 2018)

If the primary reason for the scope is to examine the sinuses, I would lean more towards using 31231. The difference between the nasal endoscopy and laryngoscopy are the structure that are being examined.  If the Larynx is also being examined, I would see the justification to use (3157X), but you also need to consider what diagnosis code you are using.  Will the diagnosis code be appropriate for the use of a laryngoscopy? Hope this helps.


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## ENTcoderConnecticut (Apr 4, 2018)

*31231 31575*

31237 is with debridement (removing exudate in nose).
31231 is without.
often coded with the old Dx 461.x


31575 is the flexible laryngoscope.
Often coded with old Dx 464.00


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## zcometa (Apr 20, 2018)

*31231 vs 92511 vs 31237 vs 31575*

31231 vs 92511 vs 31237 

92511 only examines the nasopharynx (eustachian tubes, adenoids, choanae)   simply: back of nose

31231 examines the entire nasal cavity including para nasal sinuses (source: https://www.american-rhinologic.org/position_92511?print) simply: front of nose + sinuses + back of nose

31237 is a 31231 + {biopsy/polypectomy or debridement} (remember to use the right modifier for postop FESS debridements hint: use -79) also remember that FESS(31253-57, 31259, 31267, 31276, 31287-88) and resection of turbinates (30140), which are usually done in conjunction with a FESS, do not have global periods so there is no need for the modifier and you can bill the follow up consults, too!

31575 as opposed to 92511 which examines the back of nose, 31575 examines the larynx/vocal chords. remember that the flex scope can either go through the mouth or the nose, depending on your provider, but ultimately its the structure they are examining is what is important.

maybe too much info but hope it helps.


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## MCHALE (Apr 24, 2018)

*cmchale*

Can physician who does nasal endoscope code 99203 ; while another physician codes 99203, 95004, and 95024


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## cburgett0816 (Oct 19, 2020)

zcometa said:


> *31231 vs 92511 vs 31237 vs 31575*
> 
> 31231 vs 92511 vs 31237
> 
> ...


thanks so much this is what i have been needing.  Diane Hyler < CPC|CPMA


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