shellnerob
Contributor
I'm trying to find out why reimbursement for 31267 and 31257 (with modifier 50) were not allowed in this situation. Is it because it's nasal endoscope and nose is single anatomy?
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Wiki What specific terms need to be in operative note??
- Thread starter shellnerob
- Start date
Pam Warren
True Blue
Does your payer want LT and RT instead? It's a guessing game, honestly.......
Keep in mind that I am not an ENT coder, just sharing what I see in EncoderPro's coding tip for 31257. The highlighted part of this tip makes me wonder whether it's possible you're not reporting the correct combination of codes.
(And again, I am NOT an ENT coder, so I could be misinterpreting this coding tip. I'm just sharing the screenshot in case it's helpful in your research.)
freespririt0806
Guru
i would contact your payer as sinus cavities are bilateral and should be paid bilateral , either by one line posting w/ 50 mod or by 2 line posting with RT and LT or 50 mod on the 2nd line , what is the actual denial say?
shellnerob
Contributor
Thank you all for your replies! This is all very helpful and as I continue to research this one, I am referencing these suggestions.