ED Coding and Reimbursement Alert
Breathe Easy With Nasal Approach
Question: Our physician performed an intubation through the naris instead of using the endotracheal approach because of technical issues. But the physician did the rest of the procedure exactly the same way as an endotracheal intubation. Should I report 31500 even though the procedure wasn't technically endotracheal? Indiana Subscriber
Answer: Yes, you should report 31500 (Intubation, endotracheal, emergency procedure) for the procedure even though the physician inserted the tube through the patient's nose instead of the mouth.
The purpose of an endotracheal intubation a procedure by which the physician inserts a flexible, plastic tube through the mouth down into the trachea (the large airway from the mouth to the lungs) is to allow air to pass to, and from, the lungs to oxygenate and ventilate them. Nasal tracheal intubation achieves the same goal. It is an older procedure that ED physicians commonly did before they were comfortable using paralytic drugs. But it can still be life-saving in cases involving difficult airways. A nasal tracheal intubation works best if the patient is still breathing, as in the case of a gasping patient with chronic obstructive pulmonary disease (COPD).
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