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31256 or 31267-polyp removal included?

  1. #1
    Default 31256 or 31267-polyp removal included?
    Clearnace Sale
    Our ent physician always wants to bill 31267(Endoscopic maxillary antrostomy with removal of tissue) when he performs an endoscopic maxillary antrostomy with polyp removal, but in the CPT book notes, it states that polyp removal is included in 31256(Endoscopic maxillary antrostomy). Am i missing something?

  2. #2
    Tuscaloosa, AL
    I don't find that note. I bill 31256 for endoscopic antrostomy and 31267 for endoscopic antrostomy with polypectomy.

    Jerri, CPC

  3. #3
    In the cpt book, the notes for OMC's under 31240, it gives examples of omc's with antrostomys and it lists 31256 for maxillary antrostomy w/ or w/out the removal of polyps and it only lists 31267 if it is with removal of mucosal disease and I took an AHIMA webinar and in their packet it also states polyp removal is included in 31237-31288. I am confused.

  4. #4
    Tuscaloosa, AL
    The notes in CPT state that for anterior ethmoidectomy (with or without removal of polyps) use 31254. I understand this to mean that whether polyps are removed or are not removed FROM THE ANTERIOR ETHMOID we should bill 31254. The same thing applies to total ethmoidectomy; bill 31255 WITH OR WITHOUT polyp removal from the ethmoid sinuses.

    The first reference under 31240 reads "with antrostomy . . . use 31256". The second note reads "with antrostomy, removal of antral mucosal disease . . . use 31267". I understand this to mean that if polyps or diseased tissue is removed FROM THE MAXILLARY SINUS we should bill 31267.

    Some of the sinus endoscopic codes do specifically mention removal of tissue or polyps. For example: 31276 is frontal sinus exploration WITH OR WITHOUT REMOVAL OF TISSUE FROM THE FRONTAL SINUS; 31287 is a sphenoidotomy; and 31288 is a sphenoidotomy WITH REMOVAL OF TISSUE FROM THE SPHENOID SINUS.

    Hope this helps.

    Jerri, CPC

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