Otolaryngology Coding Alert

Question: Can we report lysis of synechia separately from other procedures? Our otolaryngologist's operative note reads, -Patient is status/post sinus surgery and has areas of adhesions that are pressing and blocking the sinuses. Therefore, I performed a lysis of the adhesions.- Is 30560 the right code for this?

Pennsylvania Subscriber Answer: If the physician performed the lysis of synechia in the nose as an open procedure (without a scope), you can report 30560 (Lysis intranasal synechia). Remember that this code applies to removal of mucosal scarring in the nose, not in the sinuses. It would be somewhat unusual for the physician to remove nasal synechia following sinus surgery, but it is possible.
 
But if the physician performed the lysis in the sinuses endoscopically, it's more likely that he performed debridement (31237, Nasal/sinus endoscopy, surgical; with biopsy, polypectomy or debridement [separate procedure]).
 
You should double-check whether the surgeon performed an open or endoscopic procedure, and whether the synechia were in the nose or sinus, before you select the appropriate code.