Otolaryngology Coding Alert

Question: What’s the difference between 30801, 30802, 30130 and 30140?

Iowa Subscriber

Answer: First, have a look at each respective code’s description:

• 30801 — Ablation, soft tissue of inferior turbinates, unilateral or bilateral, any method (eg, electrocautery, radiofrequency ablation, or tissue volume reduction); superficial
• 30802 — …intramural (ie, submucosal)
• 30130 — Excision inferior turbinate, partial or complete, any method
• 30140 — Submucous resection inferior turbinate, partial or complete, any method.

You’ll want to begin by separating fundamental surgical differences between 30801/30802 and 30130/30140. The 3080X codes involve the ablation, and subsequent reduction, of a turbinate. Turbinate ablation is most often performed using a radiofrequency technique involving a coblator, but can be performed using an electrocautery as well. Using an operative report example, a turbinate ablation procedure might sound like the following:

• “Performed inferior turbinate reduction with the coblator bilaterally, out fracturing the inferior turbinates.”

The underlying difference between 30801 and 30802 is that 30802 enters the submucosa and shrinks the inferior turbinate. 30801 involves a reduction of the size of the inferior turbinate in a more superficial manner and does not enter the submucosal soft tissue.

On the other hand, 30130 and 30140 involves resection, or excision, of the inferior turbinate; 30140 differs from 30130 in that it involves entering the submucosal plane, cutting out the inferior turbinate bone, and preserving the mucosa while taking out the bone.

In 30130, the physician cuts out the inferior turbinate and surrounding submucosal tissue. With 30140, you will want to see that the submucosa is entered and the bone is resected and removed. Have a look at two examples:

• 30140: “Using a _______ to enter the submucosa, inferior turbinate was resected and removed from the submucosa, opening the airway.”
• 30130: “Using Kennedy scissors, the inferior turbinate was excised and removed.”

Next, you’ve got to make a proper distinction between 30801 and 30802. Both involve turbinate reduction via ablation, but how you’ll decide between the codes depends on whether the surgeon advanced the coblator into the deeper mucosal tissue of the turbinate. You will report 30801 if the surgeon does not advance beyond the superficial lining of the mucosal tissue. However, if the physician documents ablation of the deeper mucosal soft tissue, then you will report 30802.