AAPC - Back to school
Results 1 to 3 of 3

Thread: getting paid in full with balloon sinus ?

  1. #1
    Join Date
    Apr 2007

    Default getting paid in full with balloon sinus ?

    AAPC: Back to School
    I know they had an article while back stating to use regular sinus codes for the balloon sinus surgery and not to use the unlisted code for ASC . Now what about the cost for the procedure , is threre a special L code that you can bill addition with or do you eat the cost ? help-
    and did anyone hear if there will be 2011 codes for sure for the balloon.
    anybody please respond ,

  2. #2


    You may already know this - but you can still use the regular ESS codes if tissue was removed before or after the balloon was used. (Check out AAO website - American Academy of Otolaryngology - click on Practice and Advocacy - then click on 'Coding Resources' - then click on 'CPT for ENT') The 31299 still needs to be used if all they did was dilate with the balloon, though. According to the AAO, there WILL be new CPT codes for the sinus ostial dilation in 2011. But knowing how fast CPT and AMA works, who knows if we'll see those for 2011. But AAO is a powerful organization, advocacy-wise, so maybe they will help it happen. I'm sure the American Rhinolgic Society is also pushing for these. I haven't gotten paid on any of my 31299's yet - still in medical review with the payers.

    Our ENT surgeons do these, which is a challenge to people like me who figure out and obsess over net revenues per case, ROA, ROE, etc. for the business. We can't charge anything additional for the balloon supply/equipment expenses to our payers because these weren't indicated in carve-outs in the contracts.... we have to negotiate them as carve outs so we can bill extra for them. Costs were figured into the 31299 charges but none of these have been paid yet.

    If anyone out there knows more, please share.

  3. #3
    Join Date
    Apr 2007


    THANKS, seems like everone has the same problem.

Similar Threads

  1. Paid-in-full discounts?
    By acerway in forum Compliance General Discussion
    Replies: 8
    Last Post: 04-08-2014, 12:42 PM
  2. Balloon dilation of sinus CPT 31297
    By jtb57chevy in forum ENT/Otolaryngology
    Replies: 1
    Last Post: 02-01-2012, 12:40 PM
  3. code for sinus surgery with balloon
    By vkratzer in forum ENT/Otolaryngology
    Replies: 3
    Last Post: 05-29-2009, 07:43 AM

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.