Look for Big Changes in ENT Procedure Coding in 2018 Look for Big Changes in ENT Procedure Coding in 2018

Look for big changes to ENT procedure coding in 2018

Endoscopy codes will see some of the biggest changes of all procedure codes next year under Medicare’s 2018 Physician Fee Schedule (PFS) final rule. Below are the highlights.

  • Brand-new endoscopy codes. CMS is introducing five new nasal/sinus endoscopy codes that each represent a bundle of services frequently reported together. These services only had placeholder CPT codes assigned in the proposed rule, but in the final rule they are as follows (including finalized values for work relative value units or wRVUs).

31241 (nasal/sinus endoscopy, surgical; with ligation of Sphenopalatine artery), 8.00 wRVUs.

31253 (nasal/sinus endoscopy, surgical with ethmoidectomy; total, including frontal sinus exploration with removal of tissue when performed): 9.00 wRVUs.

31257 (nasal/sinus endoscopy, surgical with ethmoidectomy; total, including sphenoidotomy): 8.00 wRVUs.

31259 (nasal/sinus endoscopy, surgical with ethmoidectomy; total, including sphenoidotomy, with removal of tissue from the sphenoid sinus): 8.48 wRVUs. This is a new code representing a combination of the services previously described by codes 31255 and 31288.

31298 (nasal/sinus endoscopy, surgical; with dilation of frontal and sphenoid sinus ostia). 4.50 wRVUs. This represents a combination of codes 31296 and 31297.

  • Cuts to existing endoscopy codes. The wRVUs for 10 endoscopy codes will be slashed in 2018 based on recommendations made by the AMA’s Relative Value Update Committee (RUC).

31254 (nasal/sinus endoscopy, surgical; with ethmoidectomy, partial, anterior): 4.27 wRVUs, down from 4.64

31255 (nasal/sinus endoscopy, surgical; with ethmoidectomy, total, anterior and posterior): 5.75 wRVUs, down from 6.95.

31256 (nasal/sinus endoscopy, surgical, with maxillary antrostomy): 3.11 wRVUs down from 3.29.

31267 (nasal/sinus endoscopy, surgical, with maxillary antrostomy; with removal of tissue from maxillary sinus): 4.68 wRVUs down from 5.45.

31276 (nasal/sinus endoscopy, surgical with frontal sinus exploration, with or without removal of tissue from frontal sinus): 6.75 wRVUs down from 8.84.

31287 (nasal/sinus endoscopy, surgical, with sphenoidotomy): 3.50 wRVUs down from 3.91.

31288 (nasal/sinus endoscopy, surgical, with sphenoidotomy; with removal of tissue from the sphenoid sinus): 4.10 wRVUs down from 4.57.

31295 (nasal/sinus endoscopy, surgical; with dilation of maxillary sinus ostium, transnasal or via canine fossa): 2.70 wRVUs, unchanged.

31296, (nasal/sinus endoscopy, surgical; with dilation of frontal sinus ostium): 3.10 wRVUs down from 3.29.

31297, (nasal/sinus endoscopy, surgical; with dilation of sphenoid sinus ostium): 2.44 wRVUs down from 2.64.