Otolaryngology Coding Alert

Question: Our ENT physician examined only the nose of a young patient under anesthesia for a presumptive nasal fracture. Would 92502 be appropriate? Do we need to add modifier -52?

Colorado Subscriber

Answer: A complete ENT exam performed under general anesthesia is rare, and 92502 (otolaryngologic examination under general anesthesia) should be billed, says Lee Eisenberg, MD, an otolaryngologist in private practice in Englewood, N.J., and a member of CPTs editorial panel and executive committee. Because the patient was brought under general anesthetic and an intended, medically necessary (due to the patients age) element of the otolaryngologic exam was fulfilled, the requirements of 92502 have been met. Modifier -52 (reduced services) should not be appended to the claim form.