Otolaryngology Coding Alert

Question: If the physician performs postoperative nasal endoscopy/debridement in the office, is it appropriate to use a 79 modifier since the septoplasty is what has the global attached? Or would the 58 modifier be appropriate?

Washington Subscriber

Answer: What modifier you should use depends on the circumstance in which the procedure was performed. 

Option 1: Report modifier 58 (Staged or related procedure or service by the same provider during the postoperative period) if the debridement was part of a staged procedure or if it was related to the procedure with the global period. You would use this if the debridement is related to the septoplasty (30520, Septoplasty or submucous resection, with or without cartilage scoring, contouring or replacement with graft).

Option 2: Include modifier 79 (Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period) if the debridement was unrelated to the original procedure with the global period. Most often, post op debridements are not related to the septoplasty and therefore, the 79 modifier is the appropriate modifier to use for this service.

Report 31237 (Nasal/sinus endoscopy, surgical; with biopsy, polypectomy or debridement [separate procedure]) for the endoscopy and debridement. Keep in mind that 31237 is a unilateral code. So, if a bilateral debridement is documented and performed, make sure you code 31231-50 (Bilateral procedure) to account for both sides.