Wiki 31237 during FESS procedure

ljones88

Networker
Messages
86
Location
Stuart, Florida
Best answers
0
Hi all,

I need clarification on the rules for billing 31237 during a FESS procedure....Here's the scenario:

Physician documents and bills:
-31276/50
-30140/50
-31255/50
-31256/50
-31287/50
-31237/50/59

Tissue is removed from sinus areas, but no polyps. Polyps occurred only in the nose and on the middle turbinate. Physician documents use of scope to remove the polyps but doesn't indicate any other tools used to remove the polyps from the nose and middle turbinate.

I'm stuck between appealing for 31237/50/59 or sending a corrected claim by billing 30115/50 (procedure was done in a hospital setting)

What are the rules for billing 31237 at the same time as a FESS.
 
31237 is a separate procedure. You wouldn't separately code for it along with more extensive procedures like the FESS codes you're using for the sinus work. The nasal polyps are dealt with 'on the way' to the more extensive work. Hope this helps.
 
Top