Wiki Nasal endoscopy with biopsy of nasopharyngeal mass

[Pilar10]

Hi All,

I have a provider who is taking tissue from a cystic mass from the nasopharynx with forceps by inserting a O degree endoscope into the right and left nasal cavity. The mass was sent to pathology. The doctor is coding 42804 (Biopsy; nasopharynx, visible lesion, simple) but i'm leaning more towards code 31237 (Nasal/sinus endoscopy, surgical; with biopsy) though the doctor did not check the sinuses. I'm getting thrown off with the wording in code 42804 "visible lesion".

Thank you all for prompt advise.

 

[cwpierce]

31237 is your code as the procedure was performed endoscopically. 42804 is more of an open procedure code. The checking of the sinuses are not included in 31237 as there are separate codes for that ( 31256, 31287, etc.)