You Be the Coder:
Sinusotomy Versus Endoscopy Codes
Published on Sun Dec 01, 2002
Test your coding knowledge. Determine how you would code this situation before looking at the box below for the answer.
Question: If I operate on or access three paranasal sinuses unilaterally with an intranasal approach, should I code it as combined sinusotomy (31090)?
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Answer: No, you should not report endoscopic procedures with open sinusotomycode 31090 (Sinusotomy, unilateral, three or more paranasal sinuses [frontal, maxillary, ethmoid, sphenoid]). Instead, you should report the nasal or nasal/sinus endoscopy code (31231-31294). These codes more accurately describe the intranasal approach and reimburse more than the open codes (31070-31090).
Select the correct code based on:
1. whether the procedure is diagnostic (31231-31235) or surgical (31237-31294)
2. the sinuses accessed.
For instance, if you perform a total ethmoidectomy, a maxillary antrostomy with tissue removal, and a sphenoidotomy, report each procedure performed. For the total ethmoidectomy, report 31255 (Nasal/sinus endoscopy, surgical; with ethmoidectomy, total [anterior and posterior]). For the maxillary antrostomy with removal of tissue, use 31267 (Nasal/sinus endoscopy, surgical, with maxillary antrostomy; with removal of tissue from maxillary sinus). For the sphenoidotomy, assign 31287 (Nasal/sinus endoscopy, surgical, with sphenoidotomy).
The sinusotomy codes have 90-day global periods, which the endoscopy codes don't.
Remember to indicate clearly the approach, including a note on the scope. A better operative report will help your coders to report your services correctly and support you in the event of an audit. |
