Question

parenthetical notes below surgery section codes 31575,31776, and new conde 31572 were revised to instruct coders to not report 31575,31576, and 31572 with other codes (e.g. 31231,31576,31578 respetively). how should a coder interpret this guidance?

Answer 1

CPT: Flexible Laryngoscopy

• Diagnostic 31575
• 31575 Flexible Laryngoscopy when the endoscope is moved further down to the level of the Larynx
• Biopsy 31576
• Excision 31578
• 31231 Nasal Endoscope the anterior portion of the nasal cavity { meatus, turbinates, the opening of the sinus
• cavities}
• 31579 is Stroboscopy
• CPT 31572: Under Endoscopy Procedures on the Larynx
• Diagnostic 31231 *description reads bilateral

These can be essential procedures. The 31231 can be done while doing 31575 procedure, so you can only bill either or depending on how far down the endoscope went.

If just the nose is examined, then 31231, if the nose and throat are examined 31575can be used.

If the physician uses a nasal endoscope for viewing the internal structure of the nose and utilizes a topical anesthetic to the oral cavity, pharynx, and larynx and uses a nasal or oral approach to insert a flexible fiberoptic laryngoscope, the bill by appending modifier -59 with CPT 31231.

CPT 31231 has higher RVU than CPT 31575. So while billing, the first bill should be the laryngoscopy followed by nasal endoscopy by appending -59

These are the laryngoscopy codes revised for 2017.These procedures make the use of a flexible laryngoscope so can be performed in the physician’s office or operating room.

New guidelines state not to report 31575 with 31231 Nasal endoscopies, diagnostic, unilateral or bilateral (separate procedure) unless both are performed under separate conditions using separate endoscopes.¹ If you report together clearly state the clinical rationale to support both codes. Both procedures can be separately documented.

References:

1, https://www.aapc.com/blog/37848-learn-the-latest-in-otorhinoloryngology/