Endoscopic Resection of Recurrent Juvenile Angiofibroma

jackjones62

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Niantic, CT
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Does anyone have experience with the endoscopic resection of juvenile angiofibroma???? ENT surgeon describes this as the endoscopic resection of anterior skull base vascular tumor, both the approach and resection done via endoscopy.

He goes on to describe that there was a large vascular mass extending from the right pterygomaxillary fossa; it encroached on the entire posterior nasal cavity; pt. did undergo embolization the day before but a good amount of bleeding was encountered due to the vascular nature of this tumor.

I understand that we should not use an "open" code for an endoscopic approach but does this rule apply to the resection as well? My surgeon wants me to use CPT 61600 - Resection or excision of neoplastic, vascular or infectious lesion of base cranial fossa; extradural....would I be stretching too far to suggest CPT 31299 - for the endoscopic approach including resection of the posterior nasal cavity and the definitive resections of the tumor with CPT 61600??? The surgeon did use cautery, suction and forceps to remove the tumor piecemeal.

Any guidance or suggestions would be greatly appreciated!

Jennifer
CENTA
 
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