ED Coding and Reimbursement Alert

Reader Question:

Epistaxis

Question: A patient comes in for epistaxis (784.7) and has packing (30905).  Packing is removed, but the epistaxis continues and the nose is repacked (30999). I attach modifier -76 to the repacking code. Is this correct? 

New York Subscriber
 
Answer: Subsequent episodes of the control of nasal hemorrhage in the posterior nasal cavity are billed using 30906 (control nasal hemorrhage, posterior, with posterior nasal packs and/or a cauterization, any method; subsequent). Do not use 30999 (unlisted procedure, nose) to indicate repacking of this area.
 
Modifier -76 (repeat procedure by same physician) would not be attached if one subsequent episode was billed (30906). If more than one subsequent episode was performed, the third, fourth, etc., episodes would require modifier -76.
 
Reader Questions and You Be the Coder reviewed by Tracie Christian, CPC, CCS-P, an emergency coding expert with Pro Code, a large ED management firm in Dallas.