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Coding tip: Know how to correctly code each procedure an otolaryngologist can perform on turbinates

Ambulatory Surgery Reimbursement Update, January 8, 2008

Procedures that otolaryngologists can perform on the turbinates include the following:

• Resections
• Excisions
• Reductions
• Ablations
• Cauterizations
• Outfracturing
• Endoscopic resection and/or excisions

When the turbinates become enlarged (hypertrophy), the enlargement causes nasal obstruction. A standard rule of thumb with these codes is that you may bill only one procedure per turbinate per side during an operative session.

For excision/resection procedures an otolaryngologist performs on the middle turbinates, use the CPT 30999 unlisted code, when billable. When an otolaryngologist performs procedures on the middle and/or superior turbinates with other turbinate procedures on the inferior turbinate(s) in the same case, you cannot bill the procedure on the middle and/or superior turbinate(s). Use modifier -50 or -RT/-LT modifiers if the otolaryngologist performs procedures on both sides. For excision of the inferior turbinate, (partial or complete, any method) use CPT code 30130.

For the submucous resection of the inferior turbinate (partial or complete, any method) use code 30140. Operative report documentation for code 30140 should reflect that the physician excised/resected/incised the mucosa. If the physician only stated that he or she "excised the turbinate(s)," it isn't enough documentation to support the use of code 30140, and would divert to the 30130 procedure . For the excision of submucous resection of the middle or superior turbinate(s), when that is the only procedure the otolaryngologist performed in that area, the CPT Manual directs you to use the 30999 unlisted code. Do not bill middle or superior turbinectomy procedures when the otolaryngologist performs the procedures on the same side as a procedure on the ethmoid sinuses.

This tip is brought to you by Ellis Medical Consulting, Inc.

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