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Lymph Node Biopsy
I took out 3 deep cervical nodes for biopsy on the left side. Can I bill 38510 x 3?
Question:
I took out 3 deep cervical nodes for biopsy on the left side. Can I bill 38510 x 3?
Answer:
No – you’d report 38510 once for any number of nodes removed from the same incision.
*This response is based on the best information available as of 07/09/20.
Intraoperative Laryngeal Nerve Monitoring with Thyroidectomy Procedures
Are we able to bill for laryngeal nerve monitoring with thyroidectomy procedure?
Question:
Are we able to bill for laryngeal nerve monitoring with thyroidectomy procedure?
Answer:
No – CPT is very clear in that intraoperative monitoring (e.g., 95940, 95941) is included in the global surgical package for the surgeon and should not be separately reported.
*This response is based on the best information available as of 06/11/20.
Nasal Endoscopy and Epistaxis Control
Can we charge a 31231 and a 30901, 30903, or 30905 if the scope is withdrawn and then the cautery is done?
Question:
Can we charge a 31231 and a 30901, 30903, or 30905 if the scope is withdrawn and then the cautery is done?
Answer:
No. CPT 31231 is a diagnostic procedure and includes the parenthetical statement “separate procedure.” That means 31231 is included in a more definitive therapeutic/treatment procedure at the same operative session. Report either CPT code 31231 or 30901 (or 30903 or 30905), but not both codes.
*This response is based on the best information available as of 05/28/20.
Coding Both Dix-Hallpike and the Epley Maneuver
I billed 95992 (Epley) and 92532 for the Dix-Hallpike I did. I got paid for 95992 but not 92532. Should I have used a modifier to get paid and should we appeal the denial?
Question:
I billed 95992 (Epley) and 92532 for the Dix-Hallpike I did. I got paid for 95992 but not 92532. Should I have used a modifier to get paid and should we appeal the denial?
Answer:
No. CPT 92532 is for positional nystagmus testing without a recording such as what you did for a Dix-Hallpike maneuver. CPT allows coding both 95992 and 92532 together. That said, Medicare, and most payors, consider this service included in the E/M or other service (95992) code you reported and not separately payable. .
We consider the performing the Dix-Hallpike, without a permanent recording, to be part of the exam performed and not separately billable. We do not recommend appealing the denial.
*This response is based on the best information available as of 02/20/20.
Ear Exam Under Anesthesia
Our surgeon performed an evaluation of the external ear canal on a pediatric patient, under general anesthesia, because the child would not allow the surgeon to evaluate the ears thoroughly…
Question:
Our surgeon performed an evaluation of the external ear canal on a pediatric patient, under general anesthesia, because the child would not allow the surgeon to evaluate the ears thoroughly in the office. We cannot find a CPT code for this service. Do we use an unlisted code?
Answer:
CPT code 92502, (Otolaryngologic examination under general anesthesia) describes a complete ENT exam under general anesthesia. If only the ears were examined, then modifier 52 (reduced services) would be appended to indicate an entire otolaryngologic examination was not performed.
*This response is based on the best information available as of 01/23/20
Mastoidectomy Code Question
Is it ok to code 69641, 69642, and 69643 for procedures performed on the same ear at the same operative session?
Question:
Is it ok to code 69641, 69642, and 69643 for procedures performed on the same ear at the same operative session?
Answer:
Absolutely not. Use only one CPT code – whichever represents the procedure performed.
*This response is based on the best information available as of 12/05/19.