Wiki Nasopharyngeal mass

Q. What are the appropriate codes to report when a physician performs a nasal endoscopy and obtains multiple biopsies of the nasopharyngeal tissue in conjunction with a tonsillectomy and adenoidectomy (T&A)?

A. The physician should report only the appropriate T & A code based on the patient's age. Since an adenoidectomy removes nasopharyngeal tissue, do not report the endoscopy or mirror visualization of the nasopharynx with biopsy separately.
If the nasopharyngoscopy is endoscopically performed without adenoidectomy, report 92511 - Nasopharyngoscopy with endoscope (separate procedure); if endoscopic nasopharyngoscopy is performed with biopsy(ies), report 42999 - Unlisted procedure, pharynx, adenoids, or tonsils. Open biopsies of the nasopharynx are reported with 42804 - Biopsy; nasopharynx, visible lesion, simple or 42806 - Biopsy; nasopharynx, survey for unknown primary lesion.

Revised October 2010
Approved June 2010
Thank you Jamie for your assistance. I have another question for you, the 92511 can not be done w/ the T&A, but what about just the tonsillectomy can it be reimbursed then?
Hi, in response to your question regarding endoscopic biopsy of nasopharyngeal mass, use CPT 31237; I would not use CPT 42804 nor 42806, they are indirect visualization and are not performed endoscopically.

Thank you Jennifer, that was the code I actually went with, after much searching and brain waves bouncing in my head. I appreciate your feedback.