Otolaryngology Coding Alert

Question: We performed a septoplasty for a patient and then used a nasal endoscopy to examine his sinuses during the septoplasty's global period. Is the endoscopy separately reportable? If so, which modifier should I report on the endoscopy? Idaho Subscriber Answer: The answer depends on medical necessity. If the ENT performed the scope to merely check the healing status of the septoplasty include the scope as part of 30520's (Septoplasty or submucous resection, with or without cartilage scoring, contouring or replacement with graft) 90-day global surgical package. If the ENT performed the endoscopy, however, for a different complaint, such as sinus headaches (346.10, Migraine without aura ...) and sinusitis (473.0, Chronic sinusitis; maxillary; and 473.2, Chronic sinusitis; ethmoidal), that is a different story. In this case, you may append modifier 79 (Unrelated procedure or service by the same physician during the postoperative period) to 31231 (Nasal endoscopy, diagnostic,  unilateral or [...]