Otolaryngology Coding Alert

Reader Questions:

Resolve Denial For Computer Assisted Guidance With Sinus Surgery

Question:

Do I have any recourse if my payer starts denying computer assisted guidance with sinus surgery or pituitary surgery effective October 28, 2010? Our practice doesn't use the guidance with every surgery. We use it with revision or complicated surgeries. If so, what should I do?

Ohio Subscriber

Answer:

Look at http://www.entnet.org/Practice/Coding-for-Stereotactic-Computer-Assisted-Navigatione.cfm and you have the AAO/HNS policy on the stereotactic guidance up on their website. You should print this to a PDF and use it in your appeals. There is also an appeal letter that they wrote for practices to use back when the code was 61795 (Stereotactic computer-assisted volumetric [navigational] procedure, intracranial, extracranial, or spinal [List separately in addition to code for primary procedure]) -- so you would need to change to code to 61782 (Stereotactic computer-assisted [navigational] procedure; cranial, extradural [List separately in addition to code for primary procedure]) in the letter.  You can find that by doing a search on the ENTNet page on stereotactic guidance and the second result will give you the letter to open in Word.