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Removal of nasal cavity neoplasm

Elaine Posted Thu 28th of June, 2012 11:25:49 AM

The patient had a nasal neoplasm removed a couple of weeks ago, and code 30117 was used (90-day postop).

Now the patient returns to the office for follow-up:

Nasal mucosa moist with no active drainage. Base of the lesion is identified on the right anterior nasal septum. Using a ear speculum to isolate the area liquid nitrogen is applied to the area. Patient handled the procedure well without complication.

Pathology showed verrucaform vs. ISK

How would you code this procedure?

SuperCoder Answered Thu 28th of June, 2012 14:47:55 PM

If you go with code descriptor of 30117 Excision or destruction (eg, laser), intranasal lesion; internal approach , the term destruction is also used. The report says liquid nitrogen is applied to the area which is an indication to destruction of neoplasm.

The modifier 76 is used to indicate a “repeat procedure or service by same physician or other qualified health care professional.” It identifies that the exact same service was repeated by the same provider. According to the American Medical Association’s CPT Changes 2008: An Insider’s View, use of modifier 76 is not restricted to procedures performed on the same day. The repeated service could be surgical or diagnostic, but cannot be an evaluation and management (E&M) service. This nuance was clarified in the CPT Changes 2011: An Insider’s View. The most important thing to remember is that both services—the original and the repeat—must be described by the exact same CPT code.

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