Otolaryngology Coding Alert

Question: What codes should I report for a nasal endoscopy with a total ethmoidectomy in addition to a sphenoidotomy with tissue removal? Also, can I bill for a polypectomy separately?

Minnesota Subscriber

Answer: With the more recent update to the frontal endoscopic sinus surgery (FESS) codes, you actually will find that the following code encompasses both procedures: 31259 (Nasal/sinus endoscopy, surgical with ethmoidectomy; total (anterior and posterior), including sphenoidotomy, with removal of tissue from the sphenoid sinus). You’ll append modifier RT (Right side) to indicate laterality. You should not report a separate code for a polypectomy performed alongside those procedures.

If the surgeon documents an unusual degree of work and effort to remove the nasal polyps, you may consider use of modifier 22 (Increased procedural services) to 31259.