Keep Fighting Third-Party Bundles of 31240, 3125x
Published on Sun Jun 07, 2009
Your ENT should get paid for the extra work he performs for endoscopic resections. Are you one of the many coders who have had trouble with payers that deny endoscopic resection of concha bullosa of the middle turbinate when you report functional sinus endoscopy of the ethmoid or maxillary sinuses with an ethmoidectomy? Even though the Correct Coding Initiative doesn't bundle 31240 (Nasal/sinus endoscopy, surgical; with concha bullosa resection) with 31254 (... with ethmoidectomy, partial [anterior]), 31255 (... with ethmoidectomy, total [anterior and posterior]), 31256 (Nasal/sinus endoscopy, surgical, with maxillary antrostomy), or 31267 (... with removal of tissue from maxillary sinus), many commercial payers do, anyway. They consider the concha bullosa resection integral to opening the ethmoid sinus. They argue that the ENT has to go through the concha bullosa to get to the ethmoid anyway. Physicians beg to differ. Resection Means Extra Work When your ENT performs 31254, 31255, [...]
You’ve reached your limit of free articles. Already a subscriber? Log in.
Not a subscriber? Subscribe today to continue reading this article. Plus, you’ll get:
