# control of nasal hemorrhage



## maudys

a patient comes into the ED with epistaxis with anterior and posterior bleed.  The physicians procedure note is as follows:

An extensive clot was extracted from the left nares. Pressure was applied to control bleeding on the left. A Rhino rocket was placed in the anterior and posterior left nasal passages with control of bleeding, with sterile technique.

I used 30905 for posterior and 30901 for anterior, but I am getting an edit stating that the 30901 will be bundled into the 30905.  Is it appropriate to use the -59 modifier for different site even if they were both performed on the left because the physician indicates anterior and posterior, or would this be inappropriate?


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## 808coder

use 30905.  that is appropriate.  mod -59 shouldn't be applied.


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## maudys

when i use the 3M software, it asks for the sites, and if you list anterior and posterior, it sets up both 30901 and 30905.  it does indicate that 30901 is bundled, so is it appropriate to report it knowing that it will be bundled anyway?


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## 808coder

*epistaxis response*

personally, I don't think it is needed.  you only want to code the higher paying CPT that was treated and is documented when there are 2 codes for the same area being done.  sounds like they tried one - it didn't work to stop the epistaxis so they used the 2nd method.  

Also, you probaby shouldn't report something that is inclusive to another code unless it is clearly stated in the chart that it was "distinct/independent" to the additional code being reported for revenue purposes.

again, hope this helps and is clear.  have a great day!


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## ansada

code only more extensive procedure 30905


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