tci Outpatient Facility Coding Alert - 2014 Issue 10

Sinus Procedures: Don't Mess Up Maxillary Cyst Removal Coding

Watch when you’d be better off choosing 31256 over 31267. Sometimes a code’s wording can leave just enough gray area to throw a coder off. For instance, take 31267 (Nasal/sinus endoscopy, surgical, with maxillary antrostomy; with removal of tissue from maxillary sinus). The phrase “removal of tissue” sounds like a debridement. But what if your physician removes a polyp or cyst from the maxillary sinus? There’s no code that says “polyp removal” or “cystectomy” for that sinus. Can you still call on 31267, or should you report a less extensive code like 31256...

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