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confused about codes

Barbara Posted Tue 28th of February, 2017 09:27:33 AM
inserted a side open laryngoscope & performed rigid laryngoscope diagnostic. applied lidocaine to the cords and injected a paralyzing agent, also of note a polyp on tracheal wall and v type of obstructions w/ mature stenosis, pt was ventilated via 6.0 tube polyp was excised under endo visualization thru rigid scope. performed serial dialation using 12mm balloon and then a 14mm balloon, straddled the stenosis w/ the balloon system. dr wants t use 31571 , 31634 , 43192-- I don't feel 43192 because he used the laryngoscope for the injection...please clarify
SuperCoder Answered Wed 01st of March, 2017 06:36:23 AM

Right, since injection already given in the CPT code 31571, so need not to bill the code 43192 for submucosal injection. CPT 31571 is for laryngoscopy, direct, with injection into vocal cord(s), therapeutic; with operating microscope or telescope, in this procedure physician performs a direct laryngoscopy with therapeutic injection into the vocal cords. The physician injects the vocal cords with a therapeutic substance. The physician administers a topical anesthetic to the oral cavity, pharynx, and larynx and inserts the laryngoscope into the patient's mouth. The interior of the larynx is examined and the physician injects the vocal cord at one to three sites with the selected therapeutic substance. No other procedure is performed. An operating microscope or a telescope is used. On the other hand, in CPT 31634, physician treats a bronchopleural fistula (BPF) with bronchoscopic balloon occlusion. The physician views the airway using a flexible fiberoptic or rigid bronchoscope that is introduced through the nasal or oral cavity. The airway is anesthetized. Fluoroscopy (x-ray) may be used to assist with navigation of the bronchoscope tip to the area of the air leak, which is then assessed. A balloon catheter is placed at the site of the leak and inflated until the leak is occluded. Keeping the inflated catheter in this position, an appropriate sealant (e.g., fibrin) may be injected. Check your documentation, match with the codes description and bill.

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