Otolaryngology Coding Alert

Question: In addition to assigning 31579 for laryngoscopy with stroboscopy, we also report 70371 and 92520. Not all insurance companies pay. Is this group of codes correct to use together?


Georgia Subscriber


Answer: Yes, you may report the above combination together. The National Correct Coding Initiative (NCCI), version 11.0, doesn't bundle this code set:
  31579 - Laryngoscopy, flexible or rigid fiberoptic, with stroboscopy
  70371 - Complex dynamic pharyngeal and speech evaluation by cine or video recording
  92520 - Laryngeal function studies. Watch out: You should use the radiology code (70371) only when the otolaryngologist performs a radiological interpretation in conjunction with the video strobe. If the physician generates a computer evaluation of the swallowing study, you shouldn't bill the radiology code.

You may, however, include the work involved in the report in the visit's E/M code, when appropriate. For instance, if the otolaryngologist performs and documents a significant, separate service from the laryngoscopy, you should bill the E/M code (such as 99201-99215, Office or other outpatient visit for the evaluation and management of a new or established patient ...) appended with modifier -25, (Significant, separately identifiable evaluation and management service by the same physician on the same day of the procedure or other service).

On the other hand, when the otolaryngologist provides the radiology interpretation and owns the equipment, you should bill 70371. CMS breaks this code into technical (modifier -TC) and professional components (modifier -26). So if the physician performs the laryngoscopy in the hospital and his employed speech language pathologist (SLP) does the evaluation, you should append modifier -26 to 70371 to indicate you are billing for the SLP's work.
 
If you perform video stroboscopy in the hospital, payers may deny 70371 for these reasons:

1. The otolaryngologist doesn't employ the SLP. In this case, you shouldn't bill the pharyngeal and speech evaluation (70371) or the laryngeal function study (92520).

2. You are billing for the entire pharyngeal and speech evaluation procedure (70371). Because the hospital owns the equipment, you should bill 70371-26. If you report the global code, your 70371 charge overlaps the facility's.