Advanced Search

Otolaryngology Coding Alert

Conquer Maxillary Cyst Removal Coding Confusion

Published on Sun Jun 07, 2009

Don't be thrown because 31267 doesn't specify what kind of tissue. Sometimes a code's wording can leave just enough gray area to throw a coder off. For instance, take 31267 (Nasal/sinus endoscopy, surgical, with maxillary antrostomy; with removal of tissue from maxillary sinus). The phrase "removal of tissue" sounds like a debridement. But what if your physician removes a polyp or cyst from the maxillary sinus? There's no code that says "polyp removal" or "cystectomy" for that sinus. Can you still call on 31267, or would you have to rely on a lesser code like 31256 (Nasal/sinus endoscopy, surgical, with maxillary antrostomy)? That was the discussion at Proliance Orthopedics and Sports Medicine where Kristi Stumpf, MCS-P, CPC, COSC, ACS-OR, works. "If the surgeon removed a maxillary cyst but did not mention he removed diseased mucosa would you code 31256 or 31267?" she asked. "I searched and searched for source data [...]
You’ve reached your limit of free articles. Already a subscriber? Log in.
Not a subscriber? Subscribe today to continue reading this article. Plus, you’ll get:
  • Simple explanations of current healthcare regulations and payer programs
  • Real-world reporting scenarios solved by our expert coders
  • Industry news, such as MAC and RAC activities, the OIG Work Plan, and CERT reports
  • Instant access to every article ever published in your eNewsletter
  • 6 annual AAPC-approved CEUs*
  • The latest updates for CPT®, ICD-10-CM, HCPCS Level II, NCCI edits, modifiers, compliance, technology, practice management, and more
*CEUs available with select eNewsletters.

Other Articles in this issue of

Otolaryngology Coding Alert

View All