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30901 and 31231

Vicky Posted Mon 16th of April, 2012 12:13:10 PM

I need to know if and when it is appropriate to bill control of nosebleed and nasal endoscopy together. My physician continues to charge both procedures and I am not sure that it is appropriate to attach 59 modifier.

SuperCoder Answered Mon 16th of April, 2012 13:38:16 PM

Even though CPT 30901-59 is billable with CPT 31231, still I would suggest you to bill only 31231 because CPT 31231 code descriptor says, it's a separate procedure and higher RVUs than CPT 30901 means both procedures should not be billed at the same session, with same location, with the same scope. However, there is a possibility that sometimes surgeon uses separate instrumentation such as cautery or some other techniques for control of nasal bleeding during the endoscopy and if that is the case, then you may bill both procedures by appending modifier -59 with CPT 30901.

Vicky Posted Mon 16th of April, 2012 14:36:40 PM

Thank you again for your help with this question

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