Question: What is the CPTÒ code for this? This is all that is documented: “Using the 0-degree endoscope and a large Takahashi forceps, the middle turbinate concha bullosa was compressed on both the right and left side. Using a degree endoscope and a large Takahashi forceps, the middle turbinate concha bullosa was compressed on both the right and left side.” Does 31240 apply?
AAPC Forum Participant
Answer: In this scenario, 31240 (Nasal/sinus endoscopy, surgical; with concha bullosa resection) is the most appropriate code to describe the service the otolaryngologist performed. In the procedure, the provider treats an air pocket in the middle turbinate, or concha, that causes pain around the patient’s eyes and problems in sinus drainage. The provider incises or compresses the air pocket to resolve the condition.
However, even though 31240 is the correct code, you cannot submit it on its own on your claim, as the code represents a unilateral service, and your provider compressed air pockets on both sides of the patient’s middle turbinate. That means, depending on payer preference, you may need to add either modifier 50 (Bilateral procedure) to the code on one line of the claim; append both RT (Right side) and LT (Left side) to the code on two lines; or bill two units of 31240 on one line with no modifier.
Bruce Pegg, BA, MA, CPC, CFPC, Managing Editor, AAPC
