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Otolaryngology Coding Alert

You Be the Coder:

Use Caution with Modifier 59 for Nasopharyngeal Excisions and Biopsies

Question: Using an adenoid curette instrument, a benign neoplasm is excised from the nasopharynx canal of a 15-year-old patient and subsequently biopsied. The adenoids are left intact. Since the entire mass is fully removed, can I bill out using 42831? Wisconsin Subscriber Answer: If the physician does not remove the adenoids, then billing for 42831 (Adenoidectomy, primary; age 12 or over) is [...]