Medicare Benefits Schedule - Item 41668

Nasal polyp or polypi, removal of

Multiple Operation Rule

(Anaes.)

Fee: $250.50 Benefit: 75% = $187.90 85% = $212.95

(See para TN.8.75 of explanatory notes to this Category)

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Item 41662 is intended to cover the removal of simple nasal polyp or polypi. Simple nasal polyp or polypi are those confined to the middle meatus, the equivalent of Grade 0, 1 or 2 in any accepted clinical nasal polyp grading system.

Item 41668 is intended to cover the removal of nasal polyp or polypi extending beyond the middle meatus, the equivalent of Grade 3 or beyond in any accepted clinical nasal polyp grading system.

Appropriate documentation, ideally with photographic and / or recordings and / or diagnostic imaging evidence demonstrating the grade should be collected and retained to demonstrate the clinical need for the service as this may be subject to audit. Where photographic or diagnostic imaging is not retained, the reasons for this should be clearly documented.

Related Items: 41662 41668