Results 1 to 2 of 2

Need help with coding for Nasopharyngeal Balloon Sinuplasty

  1. Default Need help with coding for Nasopharyngeal Balloon Sinuplasty
    New Call-to-action
    I work for ENT physicians and this procedure is new to our practice. This patient has nasopharyngeal stenosis which is a rare condition. This 63 y/o male patient has nasal obstruction/congestion, surgical history of tonsillectomy and adenoidectomy as a child. Doctor wants to perform a nasopharyneal balloon sinuplasty. Doctor will also plan to do some releasing incisions to open the stenosis, then dilate and possibly place a stent while healing.

    Thanks for any help you can give.


  2. #2
    Default Balloon Dilation Nasopharynx
    I think, perhaps, like we are supposed to only code and bill the traditional FESS if a balloon dilation is performed AND some element of the traditional FESS is also done. For example, a frontal dilation is performed and the surgeon goes in endoscopically and removes some ostitic bone from the frontal sinus, we can't code 31296 for the balloon dilation. Once the scope and instruments are used and tissue is removed, we have to use the traditional FESS code,31276

    So, to your question, although the surgeon initially uses the balloon to dilate three Nasopharynx, he still has to use traditional dilation techniques.

    So there are two possibilities

    1/ bill the balloon dilation using unlisted code 31299 and equate it to 31295 for pricing and code the traditional dilation codes as well. The payer may not pay for all the dilation techniques used because what was discussed above. The more detailed the surgeon's documentation that supports the medical necessity for the multiple dilation techniques, the more ammunition you have to appeal to the payer and justify each code.

    2/ your other choice is to assume that the balloon dilation will be considered bundled ion the other dilations and just don't bill it.

    I like option 1 better

    Barbara J. Cobuzzi MBA, CPC, COC, CPC-P CPC-I CPCO, CENTC
    Consulting Editor Otolaryngology Coding Alert
    Last edited by b.cobuzzi; 02-14-2019 at 10:06 AM.

Similar Threads

  1. Balloon sinuplasty
    By cierra329 in forum ENT/Otolaryngology
    Replies: 1
    Last Post: 09-20-2018, 10:55 AM
  2. Balloon Sinuplasty Again
    By NESmith in forum ENT/Otolaryngology
    Replies: 1
    Last Post: 07-25-2012, 11:45 AM
  3. New Balloon Sinuplasty Codes
    By daknaack in forum ENT/Otolaryngology
    Replies: 3
    Last Post: 06-23-2011, 06:59 AM
  4. balloon sinuplasty
    By njbrown in forum ENT/Otolaryngology
    Replies: 5
    Last Post: 10-20-2009, 01:08 PM
  5. Balloon Sinuplasty
    By jthweatt in forum ENT/Otolaryngology
    Replies: 5
    Last Post: 03-09-2009, 12:08 PM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.