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Answer: No, you should not report endoscopic procedures with open sinusotomycode 31090 (Sinusotomy, unilateral, three or more paranasal sinuses [frontal, maxillary, ethmoid, sphenoid]). Instead, you should report the nasal or nasal/sinus endoscopy code (31231-31294). These codes more accurately describe the intranasal approach and reimburse more than the open codes (31070-31090).
Select the correct code based on:
1. whether the procedure is diagnostic (31231-31235) or surgical (31237-31294)
2. the sinuses accessed.
For instance, if you perform a total ethmoidectomy, a maxillary antrostomy with tissue removal, and a sphenoidotomy, report each procedure performed. For the total ethmoidectomy, report 31255 (Nasal/sinus endoscopy, surgical; with ethmoidectomy, total [anterior and posterior]). For the maxillary antrostomy with removal of tissue, use 31267 (Nasal/sinus endoscopy, surgical, with maxillary antrostomy; with removal of tissue from maxillary sinus). For the sphenoidotomy, assign 31287 (Nasal/sinus endoscopy, surgical, with sphenoidotomy).
The sinusotomy codes have 90-day global periods, which the endoscopy codes don't.
Remember to indicate clearly the approach, including a note on the scope. A better operative report will help your coders to report your services correctly and support you in the event of an audit. |
