Oncology & Hematology Coding Alert

Reader Questions:

Nasal Endoscopy Requires Accurate ICD-9 Coding

Question: A patient reported to our office last week for a nasal endoscopy. When does a nasal endoscopy become necessary, and what CPT/ICD-9 codes should I consider for claims?

Kentucky Subscriber

Answer: The oncologist will perform a nasal endoscopy when a patient's upper airways need examining - especially if the patient's condition is not improving or the oncologist cannot get an accurate diagnosis from a nasal septum exam.
 
On your claim, you should report 92511 (Nasopharyngoscopy with endoscope [separate procedure]) for the nasal endoscopy.
 
Also, here is a list of diagnosis codes that most Medicare carriers will consider acceptable for a nasal endoscopy:
 

  • 381.01 - Acute serous otitis media
     
  • 381.81 - Dysfunction of Eustachian tube
     
  • 381.9 - Unspecified Eustachian tube disorder 
     
  • 382.00 - Acute suppurative otitis media without spontaneous rupture of ear drum
     
  • 462 - Acute pharyngitis
     
  • 472.1 - Chronic pharyngitis
     
  • 472.2 - Chronic nasopharyngitis
     
  • 474.12 - Hypertrophy of adenoids alone
     
  • 784.2 - Swelling, mass, or lump in head and neck.