In CMS
Aug 12th, 2019
The Centers for Medicare & Medicaid Services (CMS) is proposing major payment changes to sinus endoscopy services. The 2020 Physician Fee Schedule (PFS) proposed rule (page 53) includes the following excerpt: We are proposing to apply the special rule for multiple endoscopic procedures to this family of codes beginning in CY 2020. This proposal would treat ...
Aug 19th, 2016
A Comprehensive Error Rate Testing contractor special study of Medicare Part B claims for diagnostic nasal endoscopy, submitted between April and June 2014, showed that most improper payments were due to insufficient documentation. The specific CPT® codes targeted in the study were: 31231 Nasal endoscopy, diagnostic, unilateral or bilateral (separate procedure) 31233 Nasal/sinus endoscopy, diagnost...
Nov 1st, 2011
Good documentation and a thorough understanding of anatomy and procedures will help you accurately code this service. By Laurette Pitman, RN, CPC-H, CGIC, CCS Anyone who has had chronic sinus infections knows how miserable the constant headache and facial pressure can be. Fortunately for chronic sufferers, there is a minimally invasive surgical technique to help ...
Mar 1st, 2007
Barbara J. Cobuzzi, MBA, CPC, CPC-H, CPC-P, CHCC, CRN When used appropriately, modifier 59 tells a payer that, due to special circumstances, two codes that are normally “bundled” (by either National Correct Coding Initiative, NCCI, edits or CPT guidelines) should be paid separately. But because modifier 59 is such a powerful tool — and because providers may apply it to increase payments inappropria...