Otolaryngology Coding Alert

Question: A patient came into our office with a nosebleed. My otolaryngologist provided epistaxis control using an endoscope. I reported 30901 and 31231. The patient's payer keeps bundling the nosebleed control into the endoscopy code. Should I appeal this? Illinois Subscriber Answer: The problem is with your coding, not the payer'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, code 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 the bleed, pulls out the [...]