Otolaryngology Coding Alert

Question: My physician performed FESS (functional endoscopic sinus surgery) and septoplasty on a patient who came in for packing removal a day after his surgery. Can we bill 99211?

Missouri subscriber

Answer: No, you cannot report 99211 (Office or other outpatient visit for the E/M of an established patient ...). Because the septoplasty (30520, Septoplasty or submucous resection, with or without cartilage scoring, contouring or replacement with graft) has a 90-day global period, you should include E/M services for the next 90 days.

You cannot "carve out" what part of the E/M service is related to the septum and what is related to the FESS (such as 31254, Nasal/sinus endoscopy, surgical; with ethmoidectomy, partial [anterior]). To track the packing removal, you can enter a $0 charge with 99024 (Postoperative follow-up visit, normally included in the surgical package, to indicate that an evaluation and management service was performed during a postoperative period for a reason[s] related to the original procedure).