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Use of Airway Balloon to correct deviated septum

Kashonna Posted Mon 17th of June, 2019 16:40:53 PM
Patient was diagnosed with a deviated septum along with a septal spur. After removing the septal spur, our provider placed an airway balloon and inflated it to further straighten the patient’s septum. Our provider is wanting to bill CPT code 30520. This procedure is also being performed in an office setting. What code would be appropriate to bill for this procedure?
SuperCoder Answered Tue 18th of June, 2019 03:39:21 AM

Hi Kashonna,

 

Could you please let us know if the procedure was performed through nasal endoscopy? We would also appreciate if you can provide us with a descriptive note about the procedure that was performed on the billed date of service. Which part of the nasal ostium was dilated - maxillary, frontal or sphenoid sinus ostium? This would help us identify the exact CPT code.

 

Thanks!   

Kashonna Posted Thu 20th of June, 2019 13:00:24 PM
Hello, in addition to the procedure mentioned above, our provider performed balloon dilation of the maxillary, frontal, and sphenoid sinuses. A nasal endoscope was used throughout the procedure. Here is a brief description about the airway balloon portion of the procedure: An adequate amount of lidocaine 1% with epinephrine 1:100,000 was injected, into the inferior turbinate. Procedure A stab incision was created at the head of each inferior turbinate, a submucus plane was elevated. a straight thru cut was used to remove underlying turbinate bone. The inferior turbinates were outfractured using a Boise elevator. Findings Inferior turbinate hypertrophy. Condition The patient tolerated the procedure well. A straight thru cut was utilized to remove a septal spur right, next an airway balloon 16 mm was inflated to 12 atm of pressure to further straight septum. Next, a combination of a 2mm straight kerrison and a 45 degree thru cut was utilized to remove anterior ethmoid lammellae. Hemostasis was obtained with Afrin. Is 30520 appropriate to bill in this case? Our provider is wanting to bill this code specifically for the septal correction with the use of the airway balloon.
SuperCoder Answered Mon 24th of June, 2019 04:35:21 AM

Hi Kashonna,

 

Per your provided note, please use the below mentioned CPT codes.

 

  • 31298 – For Nasal endoscopy with dilation of frontal and sphenoid sinus ostia (eg, balloon dilation)
  • 31295 - Nasal endoscopy with dilation of maxillary sinus ostium (eg, balloon dilation
  • 30520 - Septoplasty or submucous resection, with or without cartilage scoring, contouring or replacement with graft

 

There is no bundling issue between these codes, so you can bill all these codes for the performed procedures.

 

Thanks! 

Kashonna Posted Mon 24th of June, 2019 11:21:21 AM
Can you please confirm that 30520 supports the documentation provided for the nasal airway balloon?
SuperCoder Answered Tue 25th of June, 2019 03:21:42 AM

Hi Kashonna,

 

CPT code 30520 is not for nasal airway balloon dilation. As stated earlier, there are separate codes for balloon dilation (31295, 31298). CPT code 30520 should be used for submucosal resection that was performed on the billed date of service. Underlying turbinate bone was removed along with fracturing of inferior turbinate’s. You should bill CPT codes 31298, 31295 and 30520 together for the performed procedures. 

 

Hope provided information would be helpful.

 

Thanks,

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