ED Coding and Reimbursement Alert

Question: Our ED physician’s procedure notes indicates that he inserted a scope through the nose to examine the larynx. Is that a nasopharyngoscopy, and should we report the procedure as 92511?

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Answer: No, the code you listed (92511,  Nasopharyngoscopy with endoscope (separate procedure)) describes examination of the nasopharynx, not the larynx.

The code you should use is 31575 (Laryngoscopy, flexible; diagnostic) even if the physician inserts the scope through the nose. The physician may choose to insert the scope into the nose or mouth, depending on patient comfort. But the focus of the exam you described is the larynx, which is proximal to the nasopharynx.

Key: Choose the code based on the anatomic area examined, not the insertion point. If the surgeon had examined the nasopharynx, then you would report 92511. The area examined for 92511 may include the posterior edge of the soft palate to the nasopharyngeal wall, including the Eustachian tube openings.