February 1, 2018

Question:
I’m confused on what to do when bilateral total ethmoidectomies were performed with a right sphenoidotomy. Do I report the new bundled code, 31257, with 31257-52 (reduced services)?

Answer:
Good question! In your situation you would report the following:

31257, RT Right total ethmoidectomy and sphenoidotomy

31255-59, LT Left total ethmoidectomy

So you use the bundled code for one side, then the individual sinus code appended with modifier 59 (distinct separate procedure) for the other side.

*This response is based on the best information available as of 02/01/18.