A surgeon is disputing our procedural coding on the following operation. I’d like to check our work and if correct, find some official source that may help explain to him why we’ve chosen the code we did. We selected 30999 unlisted procedure, nose because there is no code describing a nasal mass excision via scope….the surgeon wants us to use 30117 Excision/destruction, intranasal lesion, internal approach, which I don’t think is accurate. I don’t code ENT much anymore, so I may be off base and would really appreciate feedback from more experienced ENT coders.

If it matters, pathology came back as:

DIAGNOSIS
Nasopharynx, biopsy:
Nasopharyngeal mucosa with reactive lymphoid hyperplasia.

PROCEDURE PERFORMED: Removal of nasopharyngeal mass.

PROCEDURE: The patient was identified, taken back to the operating suite, placed in a supine position and administered a general endotracheal anesthetic by the department of anesthesia. After being successfully induced, I directed my attention to the nasal cavity where a 0 degree scope was used to identify the right nasal cavity. The scope was taken into the nasopharynx where a nasopharyngeal mass was noted. Using Tru biting forceps and Takahashi biting forceps the mass was removed and sent to pathology. Cauterization was done intranasally and through orally until the bleeding was controlled. The patient tolerated the procedure well and was sent to the postanesthesia recovery unit in satisfactory and stable condition. Postop instructions were discussed with the family instructions to follow up in the office in six weeks or sooner pending pathology results.