Otolaryngology Coding Alert
Use Modifier -50 for Bilateral FESS
Question: Should we append modifier -50 (Bilateral procedure) to 31237 (Nasal/sinus endoscopy, surgical; with biopsy, polypectomy or debridement [separate procedure])? Florida Subscriber Answer: Yes. With the exception of 31231 (Nasal endoscopy, diagnostic, unilateral or bilateral [separate procedure]), functional endoscopic sinus surgeries (FESS) are unilateral procedures that may be appended with modifier -50 if the surgery is performed on both sides of the nose. Depending on the carrier, the bilateral procedure is reported on either one line or two. Most private carriers prefer two lines: The majority of Medicare carriers, meanwhile, require a one-line submission: Note: Some carriers require modifiers -LT (Left side) and -RT (Right side) instead of modifier -50. You Be the Coder and Reader Questions answered by Randa Blackwell, financial specialist with the otolaryngology division of the department of surgery at the University of Maryland in Baltimore; Barbara Cobuzzi, MBA, CPC, CPC-H, an otolaryngology coding and reimbursement specialist and president of Cash Flow Solutions, a medical billing firm in Lakewood, N.J.; Lee Eisenberg, MD, an otolaryngologist in private practice in Englewood, N.J.; Tara Kaye, appeals coordinator with Atlanta ENT, a large otolaryngology practice with offices throughout metropolitan Atlanta; Melissa Pointer, CPC, billing manager with the otolaryngology division at the University of Arkansas for Medical Sciences in Little Rock; and Teresa Thompson, CPC, an otolaryngology coding and reimbursement specialist in Sequim, Wash.
Otolaryngology Coding Alert
- Payment for Canalith Repositioning Procedure Is Carrier-Specific
Otolaryngologists frequently use canalith repositioning to treat patients with benign paroxysmal positional vertigo (BPPV). No [...] - Request, Review, Return:
Meet the Three Rs of Consultations
You should code a consultation if the otolaryngologist:
provides the requesting physician with a [...] - You Be the Coder:
Removal of PE Tubes
Test your coding knowledge. Determine how you would code this situation before looking at the [...] - Reader Question:
Laceration Repair
Question: If residents under my supervision in the emergency department repair a laceration, should I [...] - Reader Question:
Radiofrequency of Soft Palate
Question: How should I code radiofrequency reduction of the soft palate? Indiana Subscriber Answer: Radiofrequency [...] - Reader Question:
Preoperative Counseling
Question: We have a father and a son scheduled for surgery on the same day. [...] - Reader Question:
Payment for Snoreplasty
Question: Our otolaryngologist performed an injection to harden the uvula and palate for snoring. Is [...] - Reader Question:
X-Ray Interpretations
Question: The otolaryngologist I work for reads CT scans and MRIs and wants to bill [...] - Reader Question:
New or Established Patient
Question: The otolaryngologist sees a patient in the hospital and performs a tracheostomy (31600, Tracheostomy, [...] - Reader Question:
Modifiers and Thyroidectomy
Question: A patient had surgery for bilateral partial thyroid lobectomy (60210-50), with a diagnosis of [...] - Reader Question:
Use Modifier -50 for Bilateral FESS
Question: Should we append modifier -50 (Bilateral procedure) to 31237 (Nasal/sinus endoscopy, surgical; with biopsy, [...]
