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Otolaryngology Coding Alert

Reader Question:

Supersede 31231, 31575 Edits With Modifier 59

Published on Tue Nov 22, 2011

Question: What is the correct way to code for nasal endoscopy and laryngoscopy procedures performed in the office on the same day? Idaho Subscriber Answer: You may report 31231 (Nasal endoscopy, diagnostic, unilateral or bilateral [separate procedure]) appended by modifier 59 (Distinct procedural service), and 31575 (Laryngoscopy, flexible fiberoptic; diagnostic), and get separate reimbursement for each code -- but in very rare instances. (See the article "31231, 92511 and 31575: Weigh Your Code Selection Options Based On Complaints," which appeared on October 2011 Otolaryngology Coding Alert, discussing the same topic.) The National Correct Coding Initiatives (CCI) specifically indicates, "CMS will not modify the modifier indicators for these edits continuing to allow use of NCCI-associated modifiers. A provider should not report both codes of a code pair edit if the nasal endoscopy can be performed with the same flexible endoscope utilized for the laryngoscopy. However, we understand that there are very occasional circumstances [...]
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