Otolaryngology Coding Alert

You must bundle cautery to same-session excision or submucous resection

You should now limit two cautery/ablation codes to procedures of the inferior turbinates only. CPT 2006 revised the definitions of 30801 and 30802 to specify Cautery and/or ablation, mucosa of inferior turbinates, unilateral or bilateral, any method; superficial and - intramural, respectively (new text underlined).

In other words: You should not apply 30801 or 30802 for procedures involving the middle or superior turbinate(s), as you might have in the past. CPT made the change because -The middle and superior turbinates are rarely treated with cautery and/or ablation,- according to the AMA's CPT Changes 2006: An Insider's Guide.

Lean on -Unlisted- for Other Locations

A new parenthetical note accompanying 30801 and 30802 directs you to report 30999 (Unlisted procedure, nose) for the rare cautery and/or ablation of the superior or middle turbinates, says Cheryl Odquist, CPC, a reimbursement and compliance consultant and president of Codeology in San Diego.

Radiofrequency rules: Similarly, for radiofrequency coblation of the inferior turbinates, you may report 30802. For radiofrequency of the middle (or superior) turbinates, however, you must turn to 30999.

Remember that when using the unlisted-procedure code, you will have to provide the payer with full documentation and additional information.

Get the whole story: For complete information on reporting unlisted-procedure codes, see -3 Tips Mean -Unlisted- Doesn't Have to Mean Unpaid- on page 92 of the December 2005 Otolaryngology Coding Alert.

Cautery and Excision, Submucous Resection Don't Mix

A second parenthetical note following 30801-30802 further instructs you not to report these cautery/ablation procedures with turbinate excision 30130 (Excision inferior turbinate, partial or complete, any method) or submucous resection 30140 (Submucous resection inferior turbinate, partial or complete, any method).

Excision, submucous resection are primary: If the ENT performs both excision and cautery/ablation, the excision is the primary service and you should report 30130 only, according to CPT Changes. Likewise, if the surgeon performs cautery/ablation with submucous resection as described by 30140, you should claim 30140 only.

Look for other restricted turbinate procedures: As with 30801 and 30802, you should restrict codes 30130, 30140 and 30930 (Fracture nasal inferior turbinate[s], therapeutic) to procedures involving the inferior turbinates only, Odquist says.

And, as with 30801-30802, you should not report 30930 with primary procedures 30130 (excision) or 30140 (submucous resection).

Learn more: For more information on 30130, 30140 and 30930, see -CPT 2006 Revises Turbinate Surgery Codes,- December 2005 Otolaryngology Coding Alert, page 91.