Otolaryngology Coding Alert

Although the April Otolaryngology Coding Alert article "Stop Draining Sinus Surgery Reimbursement With 7 Tips" advocates reporting 31233 (Nasal/sinus endoscopy, diagnostic with maxillary sinusoscopy [via inferior meatus or canine fossa puncture]) and 31235 (Nasal/sinus endoscopy, diagnostic with sphenoid sinusoscopy [via puncture of sphenoidal face or cannulation of ostium]), the surgeon must use the approach outlined to report the code.

For instance, to assign 31233, the otolaryngologist must enter the maxillary sinus through either a puncture of the canine fossa or a window underneath the inferior turbinate. To report 31235, the surgeon enters the sphenoid sinus and performs work inside the sinus. ENTs rarely use these procedures in the office.

Before billing these codes, make sure that they are applicable and that your physician has performed and documented the required approach.