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Laryngoscopy performed prior to tracheostomy, direct laryngoscopy, and esophagoscopy


Stuart, Florida
Best answers
Hey all,

I have a question re: 31575. Patient was seen 5/12 at around 8am. Physician performed 31575. Physician decided 31600 and 31525 should be completed later around 4pm. Physician performed 31600 first followed by 31525 with a Jako laryngoscope, and 43191 with a #8 esophagoscope in the OR. Direct laryngoscopy (31525) went down to the esophagus. 43191 was entered through the nose and down to about 30 cm into the esophageal inlet where the tumor was visualized and then removed. No cell washing done, no biopsy taken, and no operating microscope was used.

Dr is trying to bill 31575, 31600, 31525, and 43191...However NCCI does not allow a modifier with code pair 43191 and 31575. Also according to NCCI, 31525 may require a modifier when billed with 43191.

Am I correct to advise that 31575 cannot be billed regardless of the encounter because it was done on the same day? Would we also be able to bill 31525/59 and 43191 because 2 different scopes were used and 2 different anatomic sites were examined?