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Otolaryngology Coding Alert

Check This Bundling Guide Before You Report Middle Turbinate Surgery

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Work values for ethmoidectomy codes (31254-31255, Nasal/sinus endoscopy, surgical; with ethmoidectomy -) include middle turbinate resection and submucous resection (both coded as 30999, Unlisted procedure, nose), but not endoscopic resection of concha bullosa (31240, Nasal/sinus endoscopy, surgical; with concha bullosa resection). Therefore, you can avoid under-reporting and overreporting of middle turbinate with ethmoidectomy if you follow these bundling rules. When an otolaryngologist operates on the ethmoids (31254-31255) and middle turbinates:

Rule 1: You should separately bill for endoscopic concha bullosa resection (31240) when performed in addition to ethmoidectomy (31254-31255).

Rule 2: Include middle turbinate excision or submucous resection (both classified as 30999) in ethmoidectomy (31254-31255). Do not separately bill 30999 for middle turbinate excision or submucous resection.

(-Is Your Practice Doing Concha Bullosa Work for Free?,- Otolaryngology Coding Alert Vol. 9, No. 5.)

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