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Otolaryngology Coding Alert

READER QUESTIONS:

31505 Isn't Separate From E/M

Published on Fri Feb 24, 2006

Question: Can we report a mirror exam using 31505 in addition to a same-day E/M service?


Maryland Subscriber
Answer: The mirror exam as described by 31505 (Laryngoscopy, indirect; diagnostic [separate procedure]) is an integral component of the standard otolaryngologic exam. Therefore, you should not report 31505 in addition to a standard E/M service (e.g., 99201-99215, Office or other outpatient visit for the evaluation and management of a new or established patient ...) or consultation (e.g., 99241-99255) the ENT provides on the same date of service--even if you append modifier 25 (Significant, separately identifiable E/M service by the same physician on the same day of the procedure or other service) to the E/M service code.
 
You may consider the mirror exam as a component when determining an appropriate E/M level to describe the visit, however.

Code 31505 is a designated -separate procedure,- and therefore you should report the mirror exam using 31505 only if it is the sole service the otolaryngologist provides to the patient during the visit.
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