Q. What are the appropriate codes to report when a physician performs a nasal endoscopy and obtains multiple biopsies of the nasopharyngeal tissue in conjunction with a tonsillectomy and adenoidectomy (T&A)?
A. The physician should report only the appropriate T & A code based on the patient’s age. Since an adenoidectomy removes nasopharyngeal tissue, do not report the endoscopy or mirror visualization of the nasopharynx with biopsy separately.
If the nasopharyngoscopy is endoscopically performed without adenoidectomy, report 92511 – Nasopharyngoscopy with endoscope (separate procedure); if endoscopic nasopharyngoscopy is performed with biopsy(ies), report 42999 – Unlisted procedure, pharynx, adenoids, or tonsils. Open biopsies of the nasopharynx are reported with 42804 – Biopsy; nasopharynx, visible lesion, simple or 42806 – Biopsy; nasopharynx, survey for unknown primary lesion.
Reviewed October 2023
Published June 2010
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