Otolaryngology Coding Alert

Another code you can easily confuse with 92511 is 31231 (Nasal endoscopy, diagnostic, unilateral or bilateral [separate procedure]). Once again, however, the area the physician examines provides you with the keys to proper coding.

-Diagnostic nasal endoscopy studies the anatomic region extending from the nostrils to the posterior edge of the soft palate,- says Empire Medicare policy L19478. -And nasal endoscopy also examines structures in the nasal cavity, such as the nasal septum, turbinates, and the floor of the nose.-

These factors distinguish 31231 from nasopharyngoscopy (92511), during which the ENT examines the area posterior to the soft palate (the anatomic region extending from the posterior edge of the soft palate to the nasopharyngeal wall, including the eustachian tube opening). Empire's policy goes on to warn, -Diagnostic nasal endoscopy and nasopharyngoscopy should not be used interchangeably.-

Bottom line: You can't take a -close enough- approach when choosing from among 31231, 31575 and 92511. Not only could you lose reimbursement, but payers are watching closely to catch your mistakes.