An otolaryngologist almost lost his license for billing multiple turbinate procedures, says Barbara J. Cobuzzi, MBA, CPC, CPC-H, CPC-P, CHCC, president of CRN Healthcare Solutions, a coding and reimbursement consulting firm in Tinton Falls, N.J. CPT 2006 instated several previously unprinted bundling issues that are critical to your practice's coding compliance. Take a few moments to review the 2006 turbinate coding changes so you don't carry any dangerous coding mistakes into 2007. Accurately Identify Inferior Turbinate Procedures Question 1: On which turbinates does an ENT perform 30130-30140, 30801-30802 and 30930?
Answer 1: These codes all apply to the inferior turbinate(s). Don't forget: CPT 2006 revised codes:
- 30130 -- Excision inferior turbinate, partial or complete, any method
- 30140 -- Submucous resection inferior turbinate, partial or complete, any method
- 30801 -- Cautery and/or ablation, mucosa of inferior turbinates, unilateral or bilateral, any method; superficial
- 30802 -- - intramural
- 30930 -- Fracture nasal inferior turbinate(s), therapeutic.
Big change: -Prior to January 2006, CPT did not specifically differentiate the turbinates,- writes Richard Waguespack, MD, AMA CPT panelist and chair, in the article -Revised 2006 Turbinectomy Guidance- published by the American Academy of Otolaryngology -- Head and Neck Surgeons (AAO-HNS). -CPT Codes 30130 and 30140 now refer specifically to the inferior turbinates (as do codes 30801, 30802 and 30930).-
Include Fracture, Destruction in Excision Question 2: Should you bill for multiple same-side turbinate procedures?
Answer: You can bill only one turbinate procedure per turbinate, Cobuzzi says. Because excision, cautery/ablation and fracture codes all apply to the inferior turbinate, you should report only one of these procedure codes per side.
Example: An otolaryngologist performs submucous resection of the inferior turbinates using laser and the2-millimeter microdebrider and bilateral outfracture of the inferior turbinates.
Code it: You should report this session with 30140. CPT considers the fracture (30930) inclusive in 30140. -Do not report 30130 or 30140 in conjunction with 30801, 30802, 30930,- states the AMA in the parenthetical instruction following 30140.
This note was added in the CPT 2006 manual at the same time that -separate procedure- was removed from the descriptors of 30801, 30802, 30930. Rationale: -Cross-references were added in support of these revisions to indicate 30130 and 30140, which report larger procedures for which removal of the inferior turbinates are [...]