Oncology & Hematology Coding Alert

Question: An established patient with throat cancer reported to the office for a diagnostic laryngoscopy. Judging by the operative notes, the patient complained of severe nausea without vomiting during the procedure. After the laryngoscopy, the physician addressed the nausea with a level-two evaluation and management (E/M) service. Can I report an E/M code in addition to the laryngoscopy code?

Minnesota Subscriber

Answer: Based on the description, you should not report a separate E/M service in this scenario. It appears that the nausea could have been a result of the laryngoscopy, so any E/M service the physician provides to treat the nausea would be bundled into the laryngoscopy code.
 
On the claim, you should report 31575 (Laryngoscopy, flexible fiberoptic; diagnostic) for the laryngoscopy.
 
You also might consider attaching ICD-9 code 149.0 (Malignant neoplasm of other and ill-defined sites within the lip, oral cavity and pharynx; pharynx, unspecified) to 31575 to prove medical necessity for the procedure.