Otolaryngology Coding Alert

Question: Our local hospital recently has purchased new equipment called Insta-Trak that my doctor is using to perform endoscopic sinus surgery (EES) procedures (31254-31294). The sales representative told him we now could use an additional code, 61795, with each ESS code. The first part of the description sterotactic computer assisted is correct but I was not sure about the rest of the wording intracranial procedure. When can I use this code?

MaryLou Ramey
Lynchburg, Va.

Answer: The wording for 61795 (stereotactic computer assisted volumetric [navigational] procedure, intracranial, extracranial, or spinal [list separately in addition to code for primary procedure]) was changed for 2000 to include extracranial and spinal, says Barbara Cobuzzi, CPC, CPC-H, CHBME, an independent coding and reimbursement specialist in Lakewood, N.J. Code 61795 is the correct code to use when the Insta-Trak is used. But you need to make sure there is medical necessity for using it and that your otolaryngologist doesnt use it with every surgery just to get paid.

Insta-Trak is one of several image guiding systems. According to Lee Eisenberg, MD, billing for using the Insta-Trak or another guiding systems is appropriate if the patient:

1. Is pediatric.
2. Is having revision sinus surgery.
3. Has sever pan-sinusitis (e.g., triad asthma)
4. Has isolated sphenoid sinusitis
5. Has isolated frontal sinusitis

Carriers will not pay for high-tech equipment if it is used only to make the physician's job easier. Also, when purchasing new equipment, otolaryngologists should seek an objective second opinion about coding concerns rather than relying solely on the word of a salesperson.