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 ...
In CMS
May 22nd, 2018
A lot of people have been asking questions about how to code FESS surgeries with the new combination codes when three or four sinuses are operated on. Sinus and FESS We have been expecting an AMA CPT® Assistant article with guidance this year, but no instructions have come from the AMA.  I went to the ...
In Billing
May 3rd, 2018
Advocates are seeking to convince the Centers for Medicare & Medicaid Services (CMS) to pay for outpatient care of patients receiving 31241 Nasal/sinus endoscopy, surgical; with ligation of sphenopalatine artery. The new code for 2018 was assigned a fee status of “inpatient only.” This is inconsistent with the current state of practice. Even though the complexity of ...
In Coding
Jan 10th, 2018
2018 brings us new functional endoscopic sinus surgery codes (FESS) which bundle a total ethmoidectomy with both a frontal sinusotomy and a sphenoidotomy with and without removal of tissue.  2018 CPT® also provides a new bundled code for a frontal and sphenoid endoscopic balloon dilation.  On initial review of these new codes and the instructions ...
Here’s the clarity you need to use new procedure codes, modifiers, and bundling rules correctly. CPT® 2018 introduces important changes for nasal/sinus endoscopy coding, including several new codes that bundle endoscopic procedures often performed together. Let’s explore these new codes, as well as other important additions and revisions. New Ethmoidectomy Codes Bundle Sphenoidotomy and More ...