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Kashonna Posted Mon 11th of December, 2017 11:26:21 AM
In reviewing the new 2018 sinus codes it is apparent that the single codes representing the ethmoid, frontal and sphenoid procedures are combined into the new 2018 combination CPT code. My dilemma is the new codes are only representative of a combination of two sinus procedures being performed at the same session (frontal/ethmoid), (ethmoid/sphenoid) (sphenoid/frontal). Therefore my question is: • If our physician performs a surgical procedure involving work on more than two of the sinus cavities (frontal, ethmoids and sphenoid) how would we bill for all three procedures? o Would we bill one new 2018 combination code that categorizes two sinus cavities and in addition on the same claim bill the old single CPT code for the remaining procedure performed on the other sinus cavity o Would we bill the old single CPT code for all three of the sinus cavities?
SuperCoder Answered Tue 12th of December, 2017 00:42:10 AM

Hi,

CPT® 2018 adds three new codes to report surgical nasal/sinus endoscopy with partial or  total ethmoidectomy. The new codes are for much more complex procedures than existing nasal endoscopy with ethmoidectomy codes (31254-31255) and involve the frontal and sphenoid sinuses. For total (anterior and posterior) nasal/sinus endoscopy with ethmoidectomy with exploration of the frontal sinus and possible removal of tissue, report 31253. Report 31257 for surgical nasal/sinus endoscopy and ethmoidectomy with excision of the sphenoid sinus (sphenoidectomy) as opposed to sphenoidotomy and 31259 for surgical nasal/sinus endoscopy with ethmoidectomy and incision into the sphenoid sinus (sphenoidotomy) for removal of tissue.

YOUR QUESTION:If our physician performs a surgical procedure involving work on more than two of the sinus cavities (frontal, ethmoids and sphenoid) how would we bill for all three procedures? o Would we bill one new 2018 combination code that categorizes two sinus cavities and in addition on the same claim bill the old single CPT code for the remaining procedure performed on the other sinus cavity o Would we bill the old single CPT code for all three of the sinus cavities

ANSWER: If your physician performs ethmoidectomy, sphenoidectomy and frontal sinus tissue removal, report appropriate cpt code from new series and one old single cpt code for remaining procedure. 

Would we bill the old single CPT code for all three of the sinus cavities? which code are you referring. Please explain. 

Thanks

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