Otolaryngology Coding Alert

Don't forget: Apply 150 percent adjustment for bilateral procedures when calculating revenue.Many coders think that coding functional endoscopic sinus surgery (FESS) is a tricky business --and with good reason. FESS is not just one operation, but rather a series of diagnostic and treatment procedures that ENTs perform with the help of rigid nasal endoscopes. However, many patients who undergo FESS will only need diagnostic procedures, not a surgical functional operation.If FESS continues to give you a hard time, the following case study could boost your confidence for distinguishing diagnostic from surgical procedures.The challenge: Examine this sample operative note, and then compare your answers to the solution from our experts.Preoperative diagnoses1. Chronic sphenoid sinusitis2. Chronic maxillary sinusitis3. Chronic frontal sinusitis4. Chronic ethmoid sinusitis5. Nasal cavity polypPostoperative diagnoses:1. Chronic sphenoid sinusitis2. Chronic maxillary sinusitis3. Chronic frontal sinusitis4. Chronic ethmoid sinusitis5. Nasal cavity polypProcedures performed:1. Bilateral sinus endoscopy with sphenoidotomy and removal of tissue from the sphenoid sinus2. Sinus endoscopy with frontal sinus exploration, bilateral3. Sinus [...]