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Off Topic :
Anyone with knowledge of Billing Codes - Invasive Surgical P

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 MeMinusOne (original poster member #25771) posted at 3:51 PM on Monday, June 16th, 2014

My fiance has felt something irritating inside his nostril for a few months. He went to an ENT to get it checked out. The ENT put a small scope about 1/4 inch into his nostril to look at it. It took all of 30 seconds. He did nothing else and told my fiance that it looks like a pimple. He gave him prescription for some form of topical antibiotic and an oral antibiotic and that was it.

My fiance received a bill for $350 for what was coded as an "Invasive Surgical Procedure". Because of this it was not covered by his insurance as a regular visit and instead is applied against his $1,000 deductible first. He questioned the doctor's office about how this was coded.

There was no cutting, scraping, poking, removal of anything of any kind done. All he did was look up his nose for 30 seconds. Is this the doctor trying to get more out of the insurance company or is it really the proper billing code? Not my area of expertise but it sounds ridiculous to me that this is coded as an invasive surgical procedure. He didn't do anything more than my kid's pediatrician does to rule out an active infection before giving a vaccine.

I'd appreciate any thoughts from anyone with knowledge in this area.

posts: 53   ·   registered: Oct. 7th, 2009   ·   location: NY
id 6837301
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Pentup ( member #20563) posted at 7:46 PM on Monday, June 16th, 2014

The $350 does not sound like an invasive procedure bill. Sounds more like an office visit to a specialist charge.

Call his insurance company and ask. If you have t he actual code, pm me and I can look it up.

Me- BS
Him- FWS (I hope- F)

posts: 8410   ·   registered: Aug. 8th, 2008   ·   location: Not Oz
id 6837670
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