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Thread: biopsy

  1. #1

    Default biopsy

    AAPC: Back to School
    The physicain did a:

    left partial ethoidectomy
    biopsy of left ethmoid bony mass

    left maxillary antrostomy
    right nasal endoscopy
    bil inferior turbinate reduction via coblation technique
    bil inferior turbinate outfracture
    image guided

    for the first two can you use 31237 and 31254 ?
    the 31254 covers the ethmoidectomy but not the biopsy
    the 31237 covers the biopsy but doesn't mention the ethmoidectomy

    Thanks for any help you can give me kdm

  2. #2
    Join Date
    Apr 2007
    Rose City Chapter

    Default biopsy woes..

    It is my experience that whether or not you can charge both codes for the ethmoid surgery depends on the report. You can bill the maxilllary antrostomy, the partial ethmoidectomy and the biopsy separately as long as the ethmoidectomy was not done for access of the biopsy. Of course, I would have to see the body of the report to support all of the coding.
    It might feel strange that you would be able to bill so many codes for one side, but the sinuses can be billed separately. Some payers might actually bundle the other procedures you have listed, but I have always billed everythng described in the report and let the payers determine the bundling.
    I hope that helps... jan

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