nlbarnes
Expert
Hello - there isn't a CCI edit for 31231 & 31238. I believe that they can be billed together only if the other procedure is performed on the other side, correct? If so, what can I give the provider to support this?
There's also a payment indicator of 3. I believe that means that if it's done via the same scope/base procedure, it's bundled or is payment reduced? If I am understanding this correctly, I would give him this, correct?
Payment indicator 3: Special rules for multiple endoscopic procedures apply if procedure is billed with another endoscopy in the same family (i.e., another endoscopy that has the same base procedure). The base procedure for each code with this indicator is identified in the Endobase field of the Medicare Physician Fee Schedule. Apply the multiple endoscopy rules to a family before ranking the family with the other procedures performed on the same day (for example, if multiple endoscopies in the same family are reported on the same day as endoscopies in another family or on the same day as a non-endoscopic procedure). If an endoscopic procedure is reported with only its base procedure, do not pay separately for the base procedure. Payment for the base procedure is included in the payment for the other endoscopy.
Procedure Note:
The cottonoid was then removed and the nasal endoscope was introduced into the nasal cavity. Several telangiectasias were noted. 1 was arising from the lateral aspect of the nasal vestibule. Another 1 was arising at the lower lateral aspect of the left nasal vestibule in the region of the inferior turbinate head. The mucosa surrounding these areas was diffusely infiltrated with 1% Xylocaine with 1 100,000 epinephrine. There was also noted to be a band of intranasal scar tissue in the anterior septum spanning across to the inferior turbinate. Both the medial and lateral base of this band of scar tissue was infiltrated with 1% Xylocaine with 1 200,000 epinephrine. After the anesthetic had a chance to take effect, the band of scar tissue was addressed first. Endoscopic straight biting forceps were used to debride the scar tissue. Following debridement the base of the excision site was cauterized with suction cautery. Subsequent to this the telangiectasia in the region of the nasal vestibule both more superiorly as well as more inferiorly on the lateral wall of the nasal vestibule were both ablated with electrocautery until hemostasis was achieved.
Thank you...
There's also a payment indicator of 3. I believe that means that if it's done via the same scope/base procedure, it's bundled or is payment reduced? If I am understanding this correctly, I would give him this, correct?
Payment indicator 3: Special rules for multiple endoscopic procedures apply if procedure is billed with another endoscopy in the same family (i.e., another endoscopy that has the same base procedure). The base procedure for each code with this indicator is identified in the Endobase field of the Medicare Physician Fee Schedule. Apply the multiple endoscopy rules to a family before ranking the family with the other procedures performed on the same day (for example, if multiple endoscopies in the same family are reported on the same day as endoscopies in another family or on the same day as a non-endoscopic procedure). If an endoscopic procedure is reported with only its base procedure, do not pay separately for the base procedure. Payment for the base procedure is included in the payment for the other endoscopy.
Procedure Note:
The cottonoid was then removed and the nasal endoscope was introduced into the nasal cavity. Several telangiectasias were noted. 1 was arising from the lateral aspect of the nasal vestibule. Another 1 was arising at the lower lateral aspect of the left nasal vestibule in the region of the inferior turbinate head. The mucosa surrounding these areas was diffusely infiltrated with 1% Xylocaine with 1 100,000 epinephrine. There was also noted to be a band of intranasal scar tissue in the anterior septum spanning across to the inferior turbinate. Both the medial and lateral base of this band of scar tissue was infiltrated with 1% Xylocaine with 1 200,000 epinephrine. After the anesthetic had a chance to take effect, the band of scar tissue was addressed first. Endoscopic straight biting forceps were used to debride the scar tissue. Following debridement the base of the excision site was cauterized with suction cautery. Subsequent to this the telangiectasia in the region of the nasal vestibule both more superiorly as well as more inferiorly on the lateral wall of the nasal vestibule were both ablated with electrocautery until hemostasis was achieved.
Thank you...