Wiki 31575 billed with 42826 & 42808

[tnjhnsn]

I need some coding advice on the following scenerio. The provider performed a Tonsillectomy on 41 year old patient (42826) and excision of lesion of pharynx (42808). At the end of the surgery, he performs a direct larynoscopy/pharyngoscopy (31575) to ensure that there weren't any more masses/lesions. We billed 42826 (474.00 as diagnosis), 42808 (784.2 as diagnosis) and 31575 (784.2 as diagnosis) out to the commercial insurance. 31575 came back denied as inclusive to other procedure (most likely the 42808 billed with same diagnosis). Is 31575 separately billable in this case? If so, is there a modifier that should be used? I would appreciate any feedback on this issue.

Thank you,
Tina J, CPC

 

[Squiabro]

Can try modifer 59 as long as medical documentation supports the medical necessity of this procedure and send copy of operative report.

 

[tnjhnsn]

Thank you. I will that a try.