# Septoplasty Etc



## andie.zurbrick (May 15, 2014)

I need help with some coding.  These are the procedures being done, but I think there may be bundling issues I am missing as I primarily do Anesthesia, not ENT.

30520  Septoplasty
30465  Bilateral Spreader Grafts
30465  Osteotomy
30140-50  Bilateral sumucous turbinate resection
20912  Septal Cartilage graft
31254  Nasal Endoscopy
31256  Nasal Endoscopy

They are having a lot done.  I am wondering, can 30465 be billed for both the osteotomy AND the spreader grafts?  The description of the code (the one with the picture) says osteotomy with graft, which to me sounds like you can only bill it once for both procedures, but I really want to make sure so I don't mess it up.  Thanks.


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## Venkatakrishnan (May 16, 2014)

Hi,

Among above listed procedures, CPT 30465 should be reported only once, since aim of the procedure is to widen the nasal cavity only. It is achieved with both osteotomy as well as spreader graft placement (both are part of 30465. For further reference use lay description). Morever CPT 20912 should not be reported separately because it has been harvested locally (septum). We can report CPT 20912 if it has been harvested from remote site like ear cartilage. As per my knowledge, the correct coding would be 30465, 30520, 30140-50, 31254, 31256.

Hope it gives some idea.


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## andie.zurbrick (May 16, 2014)

Even though the graft is removed from one part of the nose and put in another?  This all confuses me so much.  Thanks.


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## Candice_Fenildo (May 18, 2014)

Vernon Kreiss is correct. I concur with her recommendations. If you would like to de-identify the operative note and email it to me, I can look at it to be sure? 

My contact details are below.


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