january 2017

Drug Eluting Implants

In this article we will be discussing Category III codes 0406T and 0407T.

  • 0406T Nasal endoscopy, surgical, ethmoid sinus, placement of drug eluting implant;
  • 0407T with biopsy, polypectomy or debridement

1. Nasal endoscopy surgery codes include not only the surgical portion of the procedure but also nasal packing and stents or implants that are used for patency to maintain the sinus opening, achieve hemostasis or elute some type of medication, therefore you would not report a drug eluting implant code when the implant is inserted on the same sinus in which the endoscopic surgical procedure was performed.

2. Category III code 0406T is reported when it is the only procedure performed. NOTE that this code is for placement of the implant in the ETHMOID sinus only. If the implant is inserted into one of the other sinuses and it is the only procedure performed you should report unlisted CPT code 31299.

3. There will be times after the initial endoscopic sinus surgery that a patient may return for a debridement procedure due to clots or crusting or a polypectomy because of recurrent polyposis. In instances like these where a debridement or polypectomy is performed on the ethmoid sinuses along with insertion of a drug eluting implant the correct code to report would be 0407T. This is the only scenario when the implant is reported with a surgical procedure.





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