Otolaryngology Coding Alert

When you-re coding for the microscope use, find out which type of magnification your physician is using. You-re looking for terms such as "operating microscope," "surgical microscope," "binocular microscope," or "telescope" and brand names such as Zeiss, Weck or Leica.

Operating microscope: An operating microscope is a large, expensive piece of equipment found in an operating suite. It's binocular -- that is, it has two eyepieces (or even two sets of eyepieces). This is typically the equipment to which +69990 refers.

Binocular microscope: This is a smaller piece of equipment that you are likely to find in your ENT's clinic. This is typically the equipment you use 92504 to indicate.

Telescope: An ENT inserts a telescope into the patient's throat or nose. Treat a telescope the same as an operating microscope used with an endoscope for purposes of coding many procedures, such as 31526 (Laryngoscopy, direct, with or without tracheoscopy; diagnostic, with operating microscope or telescope). These are included in the codes that indicate both endoscopy and microscopy.

Other lenses: Don't confuse a microscope or telescope with a loupe (which may fit over a pair of glasses) or the ENT's hand-held otoscope. If your ENT is using lesser equipment, don't even consider coding for microsurgery.

Delve Into the Details

Learn more about PQRI for ENTs at the the American Academy of Otolaryngology-Head and Neck Surgery's Web site: http://www.entnet.org/Practice/pqriMeasures.cfm.

Not sure which ICD-9 codes match which Category II codes? Find a handy crosswalk in an Excel spreadsheet form in the PQRI Tool Kit at www.cms.hhs.gov/PQRI.