Otolaryngology Coding Seminars - Resolve Balloon Sinuplasty Questions With Three Coding Options

By Author: Angela Smith
Total Articles: 89
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With no dedicated code for a balloon sinuplasty, you are not alone if you have wondered how to code endoscopic sinus surgery involving the newer tool. However you can confidently navigate to the right code or combo code. You should focus on whether your otolaryngologist uses a balloon catheter for dilation alone or as part of a functional endoscopic sinus surgery (FESS). Do not overlook what your operative report should include and when you can code for multiple sinus procedures.
1. For dilation only, go for unlisted procedure code
In order to code for balloon sinusplasty, focus on what the otolaryngologist is using the balloon for.
If the balloon is used to dilate the sinuses only, you should report unlisted code 31299 (Unlisted procedure, accessory sinuses). On the other hand, if the procedure involves more than just dilation, like opening of the Ostia, a traditional endoscopic procedure, select an appropriate FESS code. The key is to find out if the balloon was used only for dilation.
If the otolaryngologist makes use of only ...
... a balloon catheter to dilate either the maxillary, frontal, or sphenoid sinuses, the right code is 31299. Don't use a specific FESS in addition to the unlisted FESS code 31299.
2. For traditional instrumentation use single FESS code
If the otolaryngologist makes use of a balloon for dilation but continues with more work, do not go for 31299.
Key: Figure out whether the otolaryngologist uses the balloon only in the initial part of the surgical procedure, and then continues with more work on a specific sinus.
3. Report Ethmoidectomy Separately
Do not miss this coding opportunity if the patient requires an ethmoidectomy.
If the otolaryngologist carries out a partial ethmoidectomy on the left side, for example, and then uses a balloon catheter to dilate the maxillary sinus on the right:
31254 Nasal/sinus endoscopy, surgical; with ethmoidectomy, partial [anterior] for the ethmoidectomy
31299 for the maxillary dilation.
For more of such Otolaryngology coding updates, sign up for Otolaryngology coding seminars. Once such conference is taking place in Orlando, Fl this December.