Otolaryngology Coding Alert

Question: Should I be reporting 31299 for an endoscopic septoplasty?

New Jersey Subscriber

Answer: You can find a definitive answer to this question in CPT^® Assistant (July 2015; Volume 25: Issue 7):

“It would be appropriate to report code 30520 (Septoplasty or submucous resection, with or without cartilage scoring, contouring or replacement with graft) for an endoscopic septoplasty.”

While a traditional septoplasty does not involve the use of an endoscope, the endoscope does not change the fundamentals of the procedure to a point where unlisted code 31299 (Unlisted procedure, accessory sinuses) is warranted. Specifically, an endoscopic septoplasty is just as “invasive” as a traditional septoplasty, with the same number of incisions required in both surgeries.

Note: Keep a lookout for whether the operative report reveals that the surgeon is actually performing a septoplasty using a balloon to move the septum into place (balloons are used with endoscopes). As addressed in the Otolaryngology Coding Alert (Volume 22, Number 2) article titled “Get the Full Scoop on Septoplasty Procedures Involving Balloon Dilation,” you would report code 30999 (Unlisted procedure, nose) if the surgeon does not make any incisions in order to straighten out the septum. If the surgeon does make incisions in addition to using the balloon and endoscope to straighten the septum, 30520 would be used.