Otolaryngology Coding Alert
Flush Out Diagnostic Fraud
Published on Tue Apr 01, 2003
Seeing the potential areas for reimbursement loss from FESS may start you searching for additional revenue leaks. But in your hunt for the top dollar, don't fall into fraudulent reporting and bill diagnostic sinus endoscopies or polypectomies with sinus procedures. Functional endoscopic sinus surgery (FESS) (31254-31294) includes diagnostic endoscopy (31231-31235) and polypectomy (31237). An otolaryngologist may perform any of the four diagnostic procedures, and based on what he sees, perform a sinus surgery on the same day. In that case, you should report the surgical endoscopy only. Billing both the diagnostic and surgical procedure is unbundling and inappropriate coding.
Other Articles in this issue of
Otolaryngology Coding Alert
- Stop Draining Sinus Surgery Reimbursement With 7 Tips
With sinus endoscopy surgeries ranking among some of the most common procedures otolaryngologists perform, coders [...] - Flush Out Diagnostic Fraud
Seeing the potential areas for reimbursement loss from FESS may start you searching for additional [...] - You Be the Coder:
Wake Up to Hyoid Reimbursement
Test your coding knowledge. Determine how you would code this situation before looking at the [...] - Form Letter Eliminates Post-FESS Headaches
Fight private payers that contradict Medicare rules and deny follow-up services for FESS with a [...] - Dont Let IDT Misconceptions Stick Around
Despite CPT's revision of 95027, intradermal dilutional testing (IDT), commonly called skin end point titration [...] - Reader Question:
Cut Out Graft Confusion
Question: When the doctor performs 69631, should I bill for a temporalis fascia graft? And [...] - Reader Question:
Listen to Audiograms Reason
Question: A Medicare beneficiary presents complaining only of hearing loss. After the otolaryngologist takes a [...] - Reader Question:
Start Recouping Tube Checks
Question: For 69436, can we charge for the first postoperative visit after the 10-day post-op [...] - Reader Question:
Unmask Ins and Exs of Sinus Access
Question: Does a code exist that describes a midface degloving approach? The otolaryngologist's notes say, [...] - Reader Question:
Eliminate the Normal Suspects
Question: How should I report a nasal culture when the otolaryn-gologist suspects that the patient [...]
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