Otolaryngology Coding Alert

Find out what diagnoses go with what FESS procedures.

Warning: If you can't keep track of where your surgeon is working, you could overlook separately codeable sinus procedures. To leave no dollars on the table, keep this anatomy sheet with CPT and ICD-9 crosswalk handy.

Trace your otolaryngologist's work and capture functional endoscopic surgery (FESS) procedures and related nasal and concha bullosa work using this diagram.

Test yourself: Do you see any codes you can add to this diagram? Here's a hint. The maxillary sinus, the frontal sinus, and the sphenoid sinus should have additions.

To the maximillary sinus, you should add 31295 (Nasal/sinus endoscopy, surgical; with dilation of maxillary sinus ostium [e.g., balloon dilation], transnasal or via canine fossa).

To the frontal sinus, you should add 31296 (...with dilation of frontal sinus ostium [e.g., balloon dilation]).

To the sphenoid sinus, you should add 31297 (...with dilation of sphenoid sinus ostium [e.g., balloon dilation]). You could also add the diagnosis 473.3 (Chronic sphenoidal sinusitis).

Bonus: Under the middle turbinate, you could also include 30999 (Unlisted procedure, nose). You would use this code for the excision of the middle turbinate.

ICD-10: When you're diagnosis coding system changes in 2013, look for these equivalents:

• Code 470 becomes J34.2 (Deviated nasal septum).
• Code 473.0 becomes J32.0 (Chronic maxillary sinusitis).
• Code 473.1 becomes J32.1 (Chronic frontal sinusitis).
• Code 473.2 becomes J32.2 (Chronic ethmoidal sinusitis).
• Code 473.3 becomes J32.3 (Chronic sphenoidal sinusitis).
• Code 478.0 becomes J34.3 (Hypertrophy of nasal turbinates).
• Code 478.19 expands into three options: J34.0 (Abscess, furuncle and carbuncle of nose), J34.1 (Cyst and mucocele of nose and nasal sinus), and J34.89 (Other specified disorders of nose and nasal sinuses).