ICD 10 Coding Alert

Question: A patient came into our office with a nosebleed. My otolaryngologist provided epistaxis control using an endoscope. I reported 30901 and 31231. The patient's payer keeps bundling the nosebleed control into the endoscopy code. Should I appeal this?Illinois SubscriberAnswer: The problem is with your coding, not the payer's policy. CPT includes a specific code for endoscopic epistaxis control: 31238 (Nasal/sinus endoscopy, surgical; with control of nasal hemorrhage). In this procedure, the otolaryngologist uses an endoscope for a diagnostic evaluation of the bleeding nose and then places electrocautery instruments or lasers parallel to the endoscope to stop internal nose bleeding.In contrast, code 30901 (Control nasal hemorrhage, anterior, simple [limited cautery and/or packing], any method) accounts for only cautery and/or packing to control the nosebleed (such as 784.7, Epistaxis). When the otolaryngologist uses an endoscope for a diagnostic evaluation of the nose and the bleed, pulls out the endoscope, and then [...]