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Otolaryngology Coding Alert

Reader Questions:

31231: Ask, How Far Did The Scope Go?

Published on Mon Jan 17, 2011

Question: When reviewing my physician's notes, how should I count exam elements when they are obtained through a scope, such as 31231 or 31575? Do those elements support the E/M and the scope or just one or the other? I always thought the elements collected via the scope support the procedure only.Answer: If you are reporting an E/M service (99201-99215, Office or other outpatient visit ...) with modifier 25 (Significant, separately identifiable evaluation and management service by the same physician on the same day of the procedure or other service) and reporting the scope separately, do not include the endoscopy finding in the exam section of the E/M service. The E/M service must be separately identifiable from the scope procedure.When the ENT uses the same flexible scope to view the nasal passages, nasopharynx and/or the larynx, making the correct code choice is difficult. The standard answer is that you code [...]
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