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Coding tip: Learn the difference between nasopharyngoscopy and endoscopy procedures

Ambulatory Surgery Reimbursement Update, January 22, 2008

When the surgeon uses an endoscope to view only the nasopharynx, it is a nasopharyngoscopy procedure only. When the physician is evaluating the entire nasal cavity (to include the drainage of the sinuses), it is considered a nasal endoscopy procedure. Use CPT code 92511 for a diagnostic nasopharyngoscopy with an endoscope, which views the surface area extending from the posterior edge of the soft palate to the nasopharyngeal wall, including the eustachian tube openings. The CPT Manual designates this as a separate procedure. This code is generally bundled into both the diagnostic nasal endoscopy and diagnostic flexible laryngoscopy codes, so you would not separately bill for this procedure, unless it is the only procedure the physician performs. Medicare does not reimburse code 92511 to ASC facilities. It is not on the Medicare Grouper List or payable under APCs for 2008.

For a laryngoscopy, flexible fiberoptic; diagnostic, bill with CPT procedure code 31575. If the CPT definition includes the use of an operating microscope, it is not appropriate to code the microscope code (69990) separately. To report flexible fiberoptic endoscopic procedures, use codes 92612-92617.

This tip is brought to you by Ellis Medical Consulting, Inc.