92511 or 31575

[Bequerel]

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Which one do you all use for your scope exams? I cant tell difference between them since a normal scope exam would include comments on both the nasopharynx and larynx. Thanks

 

[BobbyHeenan]

I use 92511 - I enter via the nasal canal and always examine the nasopharynx as well and dictate as such, so I figure that's what I should use.

As an aside, we have had private insurers not want to pay for follow up scope exams in patients that are NED. We have had to submit additional codes like dysphagia, hoarseness, etc and delineate those symptoms specifically in the impression/plan part of our notes in order for the follow up scope to be paid for. Ridiculous. If I have a completely asymptomatic patient s/p XRT for a head and neck malignancy some insurers won't pay for the follow up scopes. So dumb.

 

[Bequerel]

thanks. Does 92511 reimburse more? If so, seems counter-intuitive since 31575 is suppose to include 92511.

 

[BobbyHeenan]

thanks. Does 92511 reimburse more? If so, seems counter-intuitive since 31575 is suppose to include 92511.

Reimbursement appears nearly identical.

I use this as a rough estimate for medicare reimbursement rates....

https://www.cms.gov/apps/physician-...h-results.aspx?Y=0&T=0&HT=0&CT=3&H1=92511&M=1

 

[Gfunk6]

I bill 31575


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