Otolaryngology Coding Alert
Report Codes Based on DOS, not Date of Claim Submission
Question: We have a patient who underwent a nasopharyngoscopy with a right-sided balloon eustachian tube dilation on December 27, 2020. Can I report code 69705? Arkansas Subscriber Answer: Unfortunately, the surgery is just outside of the date that code 69705 (Nasopharyngoscopy, surgical, with dilation of eustachian tube (ie, balloon dilation); unilateral) goes active. For dates on or beyond Jan. 1, 2021, you may report this service with 69705 and modifier RT (Right side). For a service performed in 2020, you will report code 69799 (Unlisted procedure, middle ear) and take the necessary steps in order to get it reimbursed. The only difference for this process is that in years past you’d typically report code 31296 (Nasal/sinus endoscopy, surgical, with dilation (eg, balloon dilation); frontal sinus ostium) as a comparison code and state in Box 19 of the CMS-1500 form the percentage of work performed as compared to code 31296. If you’re submitting the claim in 2021, you may now use code 69705-RT as a comparison code and subsequently state in Box 19 that the provider performed 100 percent of the work involved in 69705-RT.
Otolaryngology Coding Alert
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