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News -> February, 1999 News
As all otolaryngologists are aware, the American Rhinologic Society with
the support of the American Academy of Otolaryngology Head and Neck Society
established guidelines with HCFA concerning FESS coding and reimbursement.
The most significant issues resolved were rates of reimbursement for multiple
endoscopic codes in FESS as well as the establishment of a ZERO day global
period for FESS codes including 31237, therefore permitting reimbursement
for debridement until healing occurs. The continuing development and merger
activity of nationwide health care carriers has created significant
variations in policy concerning FESS reimbursement.
The ARS Board has recognized the potential impact of these variations upon
its members as well as all otolaryngologists. Therefore a socioeconomic
committee has been established with myself as chair including Fred Kuhn, M.D.,
Paul Toffel, M.D., and Robert Bumstead, M.D., as members. Our goal is to
accumulate data concerning FESS coding and reimbursement issues and to
correlate this information. Subsequently a socioeconomic session will
be presented during the fall 1999 ARS Meeting.
Therefore, please direct to my attention specific problems that have arisen
in your practice in relation to a divergence of health care company policy
from HCFA guidelines concerning FESS coding and reimbursement. I am urging
all otolaryngologists to become members of the ARS since we are actively
working on your behalf to establish appropriate reimbursement guidelines
for FESS surgery.
Joseph B. Jacobs, M.D.
Professor of Clinical Otolaryngology
Director of Rhinology
New York University
New York, New York
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