Otolaryngology Coding Alert

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


Question: How would you code a right-side nasal sinus endoscopy with total ethmoidectomy, plus a left-side endoscopy with partial ethmoidectomy?

Hawaii Subscriber


Answer: When a physician performs a partial ethmoidectomy on the left side and a total ethmoidectomy on the right side of a patient, both procedures should be billed, says Susan Callaway-Stradley, CPC, CCS-P, a coding and reimbursement specialist in North Augusta, S.C. The correct manner in which to bill these two procedures would be code 31255-RT (nasal/sinus endoscopy, surgical; with ethmoidectomy, total [anterior and posterior]; right side) and 31254-LT (nasal/sinus endoscopy, surgical; with ethmoidectomy, partial [anterior]; left side). Some carriers may not recognize -LT and -RT modifiers, and may use them for informational purposes only, but not for overriding bundling edits. Therefore, modifier -59 (distinct procedural service) should be attached to the 31254 and read as follows: 31255-RT, 31254-59-LT. However coded, you can expect the second procedure to be reduced by 50 percent.