Otolaryngology Coding Alert

Question: Our ENT physician performed a septoplasty (30520) and excised a papilloma in the nasal vestibule with scissors — no endoscope was used. The physician circled 31237, but I don’t see this as correct. Can you advise?

Codify Subscriber

Answer: Since the physician did not use a scope, you should not report 31237 (Nasal/sinus endoscopy, surgical; with biopsy, polypectomy or debridement (separate procedure)) for this service, because that code specifically describes an endoscopy.

Instead, you’ll report 30117 (Excision or destruction (eg, laser), intranasal lesion; internal approach) since it describes the excision but does not require you to have used an endoscope.

The National Correct Coding Initiative (NCCI) does not bundle 30520 and 30117 together, so you shouldn’t need a modifier to report the codes on the same claim. However, some payers may still want you to append a modifier, such as XS (Separate Structure…) or if the payer does not recognize the X[ESPU] modifiers, 59 (Distinct procedural service), to demonstrate the separate nature of the services.