Otolaryngology Coding Alert
Code This Complex Nasal Endoscopy
Question: With an endoscope, our physician removed a massive nasal mass obstructing the nasal vault and nasopharynx with total obstruction of all the sinuses. This was a very complex procedure that took more than an hour longer than usually required. She also removed a polyp from the maxillary sinus. What is the correct code for this operation? Arizona Subscriber Answer: Code 31267-22 (Nasal/sinus endoscopy,surgical, with maxillary antrostomy; with removal of tissue from maxillary sinus) and be ready to appeal with the documentation for the large mass and the extra time it took that justifies appending modifier 22 (Increased procedural service). It sounds like you have documentation of the extra time involved. Be as specific as possible: Compare the actual time -- which must be documented -- to the scheduled time in the operating room, for instance. Cost-effectiveness: You may find the time and effort involved in documenting modifier 22 to cost as much as the extra reimbursement you finally receive from an insurer.
Otolaryngology Coding Alert
- Epley Revisited:
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CMS: Youve got to be on top of your age, gender, dx. Most practices would [...] - Know Your Anatomy for EGD Coding
If your ENT ventures past the pharynx, youll want to review some basic anatomy. Esophagus: [...] - You Be the Coder :
Code This Complex Nasal Endoscopy
Question: With an endoscope, our physician removed a massive nasal mass obstructing the nasal vault [...] - Correction
In the You Be the Coder item in Otolaryngology Coding Alert vol. 11, no. 2, [...] - READER QUESTIONS:
You Can't Append 50 to This Laryngoscopy Code
Question: Can you bill 31541 bilaterally? I had heard awhile back that Medicare allows it; [...] - READER QUESTIONS:
Make Sure Pathologist Renders 'Uncertain' Dx
Question: What is the difference between coding a neoplasm of unspecified morphology and one of [...] - READER QUESTIONS:
Withhold Payment Until Outside Firm Gets NPIs
Question: Our client practice, an otolaryngology group, employs several audiologists. We have their NPI numbers [...] - READER QUESTIONS:
CCI Bundles PE Tube with Tympanoplasty
Question: If the surgeon performs a tympanoplasty without mastoidectomy or ossicular chain reconstruction (69631) and [...] - READER QUESTIONS:
Look to Add-On Code When Doc Takes Extra Time
Question: Our physician got called for an inpatient consultation for patient with epistaxis. The nasal [...] - READER QUESTIONS:
No Modifier Necessary When It's Not Co-Surgery
Question: We performed a tongue biopsy on a patient while the patient was in the [...] - READER QUESTIONS:
Modifier 52 Helps Describe Resection, Outfracture
Question: I have a physician who wants to bill both 30140 and 30930 during the [...]
