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Sinus surgery billing

Tammi Posted Tue 08th of November, 2011 20:52:56 PM

Can you bill for 61781 for removal of polyps - FESS completed.

SuperCoder Answered Wed 09th of November, 2011 00:14:35 AM

CPT 61781 is not billed for polyp removal.

61781 Stereotactic computer-assisted (navigational) procedure; cranial, intradural
61782 Stereotactic computer-assisted (navigational) procedure; cranial, extradural
61783 Stereotactic computer-assisted (navigational) procedure; spinal
All 3 new codes are considered add-on codes (as was CPT +61795); thus, they are not subject to the multiple procedure discount formula.
When surgical navigation is performed during routine endoscopic sinus surgery (for inflammatory conditions of the paranasal sinuses), the appropriate CPT code for surgical navigation in this instance is now CPT +61782. Since this is still an add-on code, it should be used in addition to the codes reported for the primary procedure(s). The American Academy of Otolaryngology policy statement on surgical navigation remains unchanged.
Although guidelines for documentation of CPT +61782 are not firmly established yet, it seems reasonable to follow the guidelines promulgated for the old code of CPT +61795; that is, the operative report should document the registration process, instrument calibration, review of imaging and intraoperative localization at multiple points throughout the procedure.
CPT +61781 is explicitly for intracranial/intradural surgical navigation; conceivably, endoscopic transnasal/transsinus procedures that employ surgical navigation for the intracranial portion of the surgery may be reported with this code.
For Nasal Polypectomy, you can code:
31237 : Nasal/sinus endoscopy, surgical; with biopsy, polypectomy or debridement (separate procedure)

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