Otolaryngology Coding Alert

Question: How should I code a transnasal esophagoscopy (TNE)? Louisiana SubscriberAnswer: Choose one of two CPT codes, depending on whether the TNE involved a biopsy. For a TNE in which the otolaryngologist does not perform a biopsy, report 43200 (Esophagoscopy, rigid or flexible; diagnostic, with or without collection of specimen[s] by brushing or washing [separate procedure]). When the TNE involves a biopsy, use 43202 (... with biopsy, single or multiple).Expect more payment for 43200 or 43202 when the otolaryngologist performs the TNE in the office instead of in a facility. The National Physician Fee Schedule assigns 5.59 transitional nonfacility total relative value units to 43200 as compared to 2.76 transitional facility total RVUs. Code 43202 contains 4.32 more transitional total RVUs in the office than in the facility--7.31 NF RVUs versus 2.99 RVUs.Possible ICD-9 codes you can use with a TNE include: dysphagia, 787.2reflux esophagitis, 530.11hiatal hernia, 553.3aspiration, 933.1Barrett's esophagitis, [...]