Otolaryngology Coding Alert
Reserve 31238 for Scope-Necessary Cautery
Question: When is it appropriate to bill 31238 for endoscopy and epistaxis bleeding control? Washington Subscriber Answer: You should report 31238 (Nasal/sinus endoscopy, surgical; with control of nasal hemorrhage) when the otolaryngologist can’t stop the bleeding without the endoscope. But the ENT can’t simply use the scope as an aid to see the area; they must place electrocautery, laser instruments, and/or chemical cautery parallel to the scope to control epistaxis and achieve hemostasis. Important: In these cases, the otolaryngologist could not have visualized or stopped the bleeding without the use of the endoscope, and this should be the determining factor when deciding to bill 31238. Think of this service as endoscopically assisted control of epistaxis.
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