Otolaryngology Coding Alert

Question: When an otolaryngologist performs a same-day office visit and mirror exam, should I include the diagnostic procedure in the E/M code? May I bill 31505 if the physician uses the mirror to diagnose a separate problem?Virginia SubscriberAnswer: You should never bill 31505 (Laryngoscopy, indirect; diagnostic [separate procedure]) in addition to 99201-99215 (Office or other outpatient visit for the evaluation and management of a new or established patient ...). The laryngeal mirror, or indirect laryngoscopy, is considered an integral part of an otolaryngologic examination. The findings from the mirror exam is what is counted toward the examination of the larynx as part of the ENT exam. Thus, the E/M service does not qualify as significant and separate from the procedure or warrant modifier 25 (Significant, separately identifiable evaluation and management service by the same physician on the same day of the procedure or other service).Code 31505's designation as a "separate [...]