tci Outpatient Facility Coding Alert - 2013 Issue 5

Reader Question: Ask for More Details Before Submitting 31256 for Nasal Endoscopy

Question: During a nasal endoscopy, the ENT dictated that the patent maxillary antrostomy could be seen in his view and that he completed minimal dilation of this in an inferior and anterior manner. Does this support reporting 31256? Ohio Subscriber Answer:  Your best course of action is to ask the physician for an addendum explaining how the antrostomy was performed and whether he removed any tissue. The claim might be paid with 31256 (Nasal/sinus endoscopy, surgical, with maxillary antrostomy), but it probably wouldn’t hold up during an audit without a more complete description of the procedure. ...

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