Otolaryngology Coding Alert

Nasal Endoscopy Diagnoses Will Have an Easy Transition in October.

When your otolaryngologist performs a surgical nasal or sinus endoscopy with biopsy / debridement, one code you frequently report is 31237 (Nasal/sinus endoscopy, surgical; with biopsy, polypectomy or debridement [separate procedure]). Many diagnoses related to nasal polyps, neoplasms, or other conditions can help justify the procedure.

Fortunately, most of the supporting diagnoses will be simple to find when ICD-10 becomes effective in October 2014 because their descriptors will remain the same. Consider these examples:

• 471.0 (Polyp of nasal cavity) will become J33.0 (Polyp of nasal cavity)
  
• 147.0 (Malignant neoplasm of superior wall of nasopharynx) will shift to C11.0 (Malignant neoplasm of superior wall of nasopharynx)
  
• 210.7 (Benign neoplasm of nasopharynx) will be reported as D10.6 (Benign neoplasm of nasopharynx).
  

Watch point: Some diagnosis codes supporting 31237, however, will expand to become more specific. For example, you currently report 461.1 for acute frontal sinusitis. ICD-10 will give you two options based on whether you know if the patient’s sinusitis is recurrent: J01.10 (Acute frontal sinusitis, unspecified) and J01.11 (Acute recurrent frontal sinusitis).

Coding tip: As with any diagnosis, having more details in your physician’s documentation is the first step toward selecting the most accurate codes supporting his services.