Wiki 31253 vs 31276

[LTHURBER]

I am just trying to make sure I am using the new Combo code(s) correctly. A I am reading it, IF tissue is removed from the frontal sinus along with an ethmoidectomy, it is OK to use 31253. If tissue is NOT removed from the frontal sinus along with an ethmoidectomy, then the 31276 code for frontal sinus exploration should be used, in addition to the ethmoid code 31254, or 31255.
Does that sound correct?

Lisa T., CPC

 

[JenniferB7]

Lisa,

This is confusing to everyone, so you are not alone.

The code description for CPT(R) 31253 states:

Nasal/sinus endoscopy, surgical with ethmoidectomy; total (anterior and posterior), including frontal sinus exploration, with removal of tissue from frontal sinus, when performed​

So tissue removal is included (when performed), but not required to bill the code. So, in short, if you are doing a total ethmoidectomy and frontal sinus exploration (with or without tissue removal) you would report CPT(R) code 31253. This article is a great reference: https://www.aapc.com/blog/40548-new-fess-codes-for-2018/

I hope that helps!