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NUSBalloon Sinus Dilation
Coding Clarification
CPT® codes 31256, 31276 and 31287 are not approved for coding balloon endoscopy when no tissue is removed according to a clarification recently issued by the American Medical Association (AMA). Instead, the AMA says the appropriate code for these procedures is 31299. Procedures coded with 31299 are not included on Medicare's ASC list. Therefore, ASCs that submit Medicare claims that include this code will not be reimbursed for these procedures.
ASC billers should continue to use 31256, 31276 and 31287 for sinus endoscopy procedures in which a balloon is used endoscopically, along with cutting tools, to create a sinusotomy by removing tissue with the balloon dilation considered inclusive.
The American Academy of Otolaryngology--Head and Neck Surgery (AAO-HNS) recently submitted three new codes to the AMA this past fall that would describe a stand-alone balloon procedure. According to the AAO-HNS, the AMA accepted these codes, and these codes are scheduled to be released for 2011.
If this change is impacting your ASC's ability to bill for the balloon dilation procedures your ASC performs, we would like to hear from you. Please email ASC@ascassociation.org with your ASC's name and estimated case volume for these procedures for 2010. We will use the information you provide as we work to ensure that these procedures are approved by Medicare for inclusion on the ASC list.
Source
ASC Association
www.ascassociation.org
ASC@ascassociation.org
Now besides this info, has any one read any udates on this sinus surgery,
SO i bill the regular sinus codes but what do they mean by cutting tools, are we suppose to bill certain extra codes ?the hardware that comes with it , very very costly.
Coding Clarification
CPT® codes 31256, 31276 and 31287 are not approved for coding balloon endoscopy when no tissue is removed according to a clarification recently issued by the American Medical Association (AMA). Instead, the AMA says the appropriate code for these procedures is 31299. Procedures coded with 31299 are not included on Medicare's ASC list. Therefore, ASCs that submit Medicare claims that include this code will not be reimbursed for these procedures.
ASC billers should continue to use 31256, 31276 and 31287 for sinus endoscopy procedures in which a balloon is used endoscopically, along with cutting tools, to create a sinusotomy by removing tissue with the balloon dilation considered inclusive.
The American Academy of Otolaryngology--Head and Neck Surgery (AAO-HNS) recently submitted three new codes to the AMA this past fall that would describe a stand-alone balloon procedure. According to the AAO-HNS, the AMA accepted these codes, and these codes are scheduled to be released for 2011.
If this change is impacting your ASC's ability to bill for the balloon dilation procedures your ASC performs, we would like to hear from you. Please email ASC@ascassociation.org with your ASC's name and estimated case volume for these procedures for 2010. We will use the information you provide as we work to ensure that these procedures are approved by Medicare for inclusion on the ASC list.
Source
ASC Association
www.ascassociation.org
ASC@ascassociation.org
Now besides this info, has any one read any udates on this sinus surgery,
SO i bill the regular sinus codes but what do they mean by cutting tools, are we suppose to bill certain extra codes ?the hardware that comes with it , very very costly.