Otolaryngology Coding Alert

Question: Can we code 31520 if a patient is 3 months old?

Alabama Subscriber
  Answer: Code 31520 (Laryngoscopy direct, with or without tracheoscopy; diagnostic, newborn) is used for a newborn, which CPT 2002 defines as 30 days of age or less. If the laryngoscopy is performed on a 3-month-old infant, use 31525 ( diagnostic, except newborn). If the otolaryngologist documents the additional work, risk and time involved in the procedure, modifier -22 (Unusual procedural services) may be appended to 31525. A separate note explaining why the procedure was significantly more difficult (including the age of the patient, the length of the procedure, etc.) should be included with the claim.
  You Be the Coder and Reader Questions were answered by Randa Blackwell, financial specialist with the Department of Otolaryngology-Head and Neck Surgery at the University of Maryland in Baltimore; Barbara Cobuzzi, MBA, CPC, CPC-H, an otolaryngology coding and reimbursement specialist and president of Cash Flow Solutions, a medical billing firm in Lakewood, N.J.; Lee Eisenberg, MD, an otolaryngologist in private practice in Englewood, N.J., and a member of CPTs Editorial Panel and Executive Committee; Elaine Elliott, CPC, a coding and reimbursement specialist in Jensen Beach, Fla.; Ann Hughes, CPC, coding specialist with Mid-Vermont Ear, Nose and Throat in Rutland, Vt.; and Melissa Pointer, CPC, billing manager with the Department of Otolaryngology at the University of Arkansas in Little Rock.