Intranasal Application of Medication

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Question:  

Our physicians will be starting a new treatment for chronic rhinosinusitis in patients after they have endoscopic sinus surgery and are still symptomatic. As we understand the medication, which is a gel, will be applied in the office under endoscopic visualization to the areas of the sinus mucosa where there inflammation is still present. The physician’ will perform an endoscopic exam and then apply the gel to the sites of inflammation when present.

How do we code for this endoscopic application of the gel?

Answer:

Thanks for your question! We assume you are speaking about the application of Mometasone Furoate gel. There is no code for the endoscopic “application” as the use of the endoscope is the “route” or “vehicle” to administer the drug. The scenario indicates that an endoscopic exam will be performed, thus the use of 31231 appears to be the most appropriate. A definitive CPT code recommendation can only be given once a procedure note is reviewed.