Otolaryngology Coding Alert

Question: We have a patient who was treated at the emergency room (ER) for a nosebleed and then referred to our clinic to have the packing removed. Is there a CPT® code I can report for this?

Texas Subscriber

Answer: Since the patient has already been treated for the nosebleed elsewhere, you should not consider reporting this service using a procedural code. Rather, the unpacking is considered an inclusive component of the evaluation and management (E/M) service.

If the clinic had initially treated the nosebleed using code 30905 (Control nasal hemorrhage, posterior, with posterior nasal packs and/or cautery, any method; initial), and the patient returned the same week to have the packing removed, you would still include the packing removal in the E/M visit. That’s because 30905 has a zero-day global surgery period — so you should bill any follow up visits to treat the surgery without consideration of the initial surgical code.