Endoscopic Sinus Debridements: Reportable or Not?

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Question:  

Is appropriate to bill 31237-79 at the 1 week post op for our sinus surgery patients? I can’t help but feel that service would be included in the septoplasty or the turbinate surgery performed at the same session. The physician and office manager it should be billed when performed during the global period, but I just can’t figure out why. Can you help me understand if the debridement services are or are not separately reportable during the global period?

Answer:

Thanks for your inquiry! The coding of sinus debridements and how to report is a frequently asked question. The endoscopic sinus surgery codes 31256, 31267, 31254, 31255, 31287, 31288, 31276 do not have a global period. Because there is no global period the debridement service (31237) is separately reportable after the surgery when medically necessary and supported by documentation. You are correct to question the use of the modifier 79 (unrelated surgical procedure) as the correct way to report this service. The septoplasty and turbinate surgery (30130, 30140) have 90 day global periods, thus the use of modifier 79 is required to indicate the debridement, performed at different anatomic locations is separately reportable. Remember, CPT code 31237 is a unilateral procedure and may be reported with a modifier 50.