Otolaryngology Coding Alert

Question: Weve been getting rejections lately for +61795. Under what circumstances may we use this code?

New Mexico Subscriber

Answer: You can report planning for stereotactic guidance (+61795, Stereotactic computer-assisted volumetric [navigational] procedure, intracranial, extracranial, or spinal [List separately in addition to code for primary procedure]) in addition to functional endoscopic sinus surgery (FESS) codes 31255-31288. ENTs use stereotactic guidance to plan delicate surgery. Your physician uses a computer to calculate the exact point of incision and entry before taking the patient into the operating suite.

Be prepared: You should be ready to show medical necessity for stereotaxis. The American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) states that the documentation must include these indications for stereotactic use:

" disease abutting the skull base, orbit, optic nerve or carotid artery

" cerebrospinal fluid rhinorrhea (349.81) or conditions where there is a skull-base defect

" benign (212.0) and malignant sino-nasal neoplasms

" revision sinus surgery

" distorted sinus anatomy of development, postoperative, or traumatic origin

" extensive sino-nasal polyposis

" pathology involving the complex posterior ethmoid, frontal, and sphenoid sinuses.

Answers to You Be the Coder and Reader Questions provided/reviewed by Barbara J. Cobuzzi, MBA, CPC-OTO, CPC-H, CPC-P, CPC-I, CHCC, president of CRN Healthcare Solutions in Tinton Falls, N.J.