Otolaryngology Coding Alert

Test your coding knowledge. Determine how you would code this situation before looking at the box below for the answer.


Question: When the physician does an endoscopy and epistaxis control, how do we bill and get paid for both procedures?

Vicki Davis, Kingman, Ariz.


Answer: You dont. CPT code 31231 (nasal endoscopy, diagnostic, unilateral or bilateral [separate procedure]) is bundled with control of epistaxis, says Barbara Cobuzzi, MBA, CPC, CPC-H, President, Cash Flow Solutions Inc., N.J. If the control of the epistaxis was done with the scope, however, you can bill code 31238 instead of 31231 and the control code. (For more information on this issue, see the February 2000 issue of Otolaryngology Coding Alert, Get Paid for Epistaxis Control With Endoscope, on page 11.

If the scope is on a different side (i.e., to determine if there is any potential problem with the other side), you could consider billing 31231-59-52 for a separate site (different site from where control is being done) and reduced service since 31231 is a bilateral code, Cobuzzi says.

Note: Modifier -59 should be used for a distinct procedural service; modifier-52 indicates reduced services.