Otolaryngology Coding Alert

Question: My physician wants to bill 69801 with modifier 58 two weeks after the original procedure. I believe the 90-day global period associated with 69801 was eliminated recently, but am not sure. Can you please shed some light on this?

Montana Subscriber

Answer: You are correct about the change – code 69801 (Labyrinthotomy, with perfusion of vestibuloactive drug[s]; transcanal) now has 0 global days.

Background: Prior to 2011, code 69801 had a 90-day global period so all follow-up care during that time frame (including repeat injections in the same ear) was covered by the initial code reporting. Now you can report subsequent injections separately if the physician administers them on different dates. No modifier (including 58, Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period) is needed.

Also include: Be sure to report the correct HCPCS code for the drug used during the injection. This will usually be Decadron (J1100, Injection, dexamethasone sodium phosphate, 1 mg) or gentamicin (J1580, Injection, Garamycin, gentamicin, up to 80 mg). ).

Remember: Patients who receive gentamicin treatments must remain in the office for at least 15-20 minutes of monitoring after every injection. That is time and money to the practice, which is why 69801 has a relatively high RVU (the total unadjusted non-facility RVU is 5.99).