Otolaryngology Coding Alert

Question: Using general anesthesia, our ENT physician examines only a young patient's nose for a presumptive nasal fracture. Should I report 92502? Do I need to add modifier -52?

Colorado Subscriber

Answer: You should report 92502 (Otolaryngologic examination under general anesthesia) for the exam. Otolaryngologists rarely perform a complete ENT exam under general anesthesia. Because the physician brings the child under general anesthetic to perform a medically necessary (due to the patient's age) otolaryngologic exam element, the procedure meets 92502's requirements. Therefore, you should not append modifier -52 (Reduced services) to 92502.