Otolaryngology Coding Alert

Question: My otolaryngologist injects a steroid into a patient's tympanic membrane. Should I report a kenalog turbinate injection?

Ohio Subscriber

Answer: You should bill 69801 (Labyrinthotomy, with or without cryosurgery including other nonexcisional destructive procedures or perfusion of vestibuloactive drugs [single or multiple perfusions]; transcanal), not 30200 (Injection into turbinate[s], therapeutic). Code 30200 describes a nasal turbinate injection.

When your otolaryngologist injects an anti-inflammatory steroid (such as Depo-medrol, Solu-medrol or Decadron) or aminoglycoside (for instance, gentamicin or streptomycin) into a patient's inner ear to treat vertigo, you should submit 69801 only once to represent the initial injection and any subsequent injections, because 69801 specifies single or multiple perfusions. Therefore, you shouldn't separately bill multiple injections. Otolaryngologists usually administer about three steroid injections.

Make sure you submit the drug's J code per injection. For instance, use J1100 with each Decadron injection (Injection, dexamethosone sodium phosphate, 1 mg) or J1580 (Injection, Garamycin, gentamicin, up to 80 mg) per gentamicin shot.