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Otolaryngology Coding Alert

You Be the Coder:

4 Turbinate Procedures--How Many CPT Codes?

Question: An otolaryngologist does bilateral outfracture of inferior turbinates and bilateral cautery of inferior turbinates. Should he report only 30802?

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Answer: No. The Correct Coding Initiative (CCI) bundles 30802 (Cautery and/or ablation, mucosa of inferior turbinates, unilateral or bilateral any method; intramural) with 30930 (Fracture nasal inferior turbinate[s], therapeutic). Code 30930 is the comprehensive code even though it has fewer relative value units--2.93--than 30802, which has 4.53. Therefore, you should include 30802 in 30930 and not separately bill for the cautery. You instead bill for the bilateral outfracture with 30930-50 (Bilateral procedure).

Watch out: If your surgeon instead performs the cautery unilaterally, you can bill out the opposite-side cautery. CCI would bundle only the same-sided cautery and outfracture, meaning you can still capture the cautery performed alone on the opposite side. Because 30802's descriptor is -unilateral OR bilateral,- the otolaryngologist receives full credit for performing the procedure unilaterally. The code's description does not require the surgeon to perform cautery bilaterally.

Example: An otolaryngologist performs bilateral turbinate outfracture and a left-sided cautery. CCI allows a modifier to override the 30802-with-30930 bundle when circumstances make a modifier appropriate. In this case, modifier 59 (Distinct procedural service) appropriately identifies the cautery as occurring on a separate site from the outfracture. Therefore, you should report this case as 30930-RT (Right side) and 30802-59-LT (Left side).

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