Otolaryngology Coding Alert

Question: When my physician provides epistaxis control using an endoscope, I usually code 30901 and 31231. Our payer keeps bundling the nosebleed control into the endoscopy code. Should I appeal? Nebraska Subscriber Answer: The problem is with your coding, not the insurer's policy. CPT includes a specific code for endoscopic epistaxis control: 31238 (Nasal/sinus endoscopy, surgical; with control of nasal hemorrhage). In this procedure, the otolaryngologist uses an endoscope for a diagnostic evaluation of the bleeding nose and then places electrocautery instruments or lasers parallel to the endoscope to stop internal nose bleeding. In contrast, 30901 (Control nasal hemorrhage, anterior, simple [limited cautery and/or packing], any method) accounts for only cautery and/or packing to control the nosebleed (such as 784.7, Epistaxis). When the otolaryngologist uses an endoscope for a diagnostic evaluation of the nose and that is the only procedure he performs in that anatomic area, you should report 31231 [...]