Question: Which CPT codes should I submit when an otolaryngologist performs diagnostic rhinolaryngoscopy for globus sensation in the throat? She examined the nasal passages, pharynx and larynx. Should I report 92511 and 31575?
Kansas Subscriber
Answer: You cannot bill both nasopharyngoscopy in addition to laryngoscopy. The National Correct Coding Initiative (NCCI) bundles 92511 (Nasopharyngoscopy with endoscope [separate procedure]) into 31575 (Laryngoscopy, flexible fiberoptic; diagnostic). Even though the otolaryngologist must remove one scope before inserting the other, Medicare disallows reporting the procedures together.
Most insurers don't pay for 92511. Even if you find a privatepayer that reimburses 92511, you should bill the procedure only when the otolaryngologist performs no other procedure on the same anatomic area. CPT designates nasopharyngoscopy as a separate procedure.
- Answers to You Be the Coder and Reader Questions provided by Ellen Allison, RHIA, CPC, physician billing coordinator at Roswell Park Cancer Institute in Buffalo, N.Y.; Daniel S. Fick, MD, director of risk management and compliance for the College of Medicine faculty practice at the University of Iowa in Iowa City; Charles F. Koopmann Jr., MD, MHSA, professor and associate chair at the University of Michigan's department of otolaryngology in Ann Arbor; Lorna Powell, CCS-P, owner of Quality Medical Management in Elk City, Okla.; and Julie Robertson, CPC, an otolaryngology coding and reimbursement specialist for University ENT Specialists in Cincinnati.
