Endoscopic Concha Bullosa Resection with Other Sinus Procedures

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Question:  

I did endoscopic sinus surgery (maxillary antrostomies and anterior ethmoidectomies) as well as endoscopic bilateral resection of concha bullosa. I told my biller to submit the following codes for me: 31254-50, 31256-50, 31240-50. My biller says the concha bullosa resection code is “bundled” into the other codes and she won’t submit the codes. I say it is a separate procedure and should be billed. What do you think?

Answer:

We agree with you. The work of an endoscopic concha bullosa resection (31240) is not included in the endoscopic maxillary sinus or ethmoid sinus surgery codes (31256, 31267, 31254, 31255) and may be separately reported. There is no CCI edit that bundles 31240 into the other codes. However, some payors may have their own software that does bundle 31240 so you may need to append modifier 59 to 31240 to show this procedure was distinctly separate from other procedures performed at the same operative session.