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Thread: 2nd request????

  1. #1

    Default 2nd request????

    AAPC: Back to School
    Hello all,

    This one has be stumped and wanted some thoughts.....

    Op note reads:
    Procedure Performed:
    1. Nasal endoscopy
    2. Outfracture of right inferior turbinate
    3. Biopsy x3 of naspharyngeal mass

    nasal endoscopy was performed. The right inferior turbinate was hypertrophic and causing some encroachment on the airway which would hamper biopsy. This was therefore outfx using a Boise elevator.

    We then used 18 gauge spinal needle to inject about 1cc of 1% Xylocaine with epinephrine into the nasal pharyngeal tissue. There was a lobulated mass just medial to the eustachian tube area and coming from Roseenmuller's fossa on the right side. This was asymmetrical and correlated with the increased PEF scan activity. After vasoconstriction, mulltiple biopsies of this were taken using a true-cutting forceps.

    Path came back (???)
    Collision tumor between nasopharyngeal carcinoma and extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT LYMPHOMA)

    31231 Endoscope, 30930 fracturing, and 42804 once since not different mass/or lesion
    DX 147.9, 200.31


  2. #2
    Join Date
    Apr 2007
    Milwaukee WI

    Default No endoscopy

    NOT my area of expertise, BUT ...

    31231 is for a diagnostic nasal endoscopy and is defined as a separate procedure. Since endoscopy was used as your approach, I do not believe you can code it along with the other codes.

    Please NOTE - as a rule CPT codes designated as separate procedure do NOT appear in the CCI edits, but they'll be denied as global nonetheless.

    Hope that helps.

    F Tessa Bartels, CPC, CEMC

  3. #3


    You are right thanks!!!

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