Otolaryngology Coding Alert

Question: My otolaryngologist wants to bill for the removal of a nasal septal button. I do not believe 30220 is appropriate because the button was removed, not inserted. How should this service be coded?

Wisconsin Subscriber

Answer: When a nasal septal perforation or defect is too large to repair, the otolaryngologist may use an alloplastic button to close it. Code 30220 (insertion, nasal septal prosthesis [button]) should be used for the insertion of such a device, not for its removal. Code 30300 (removal foreign body, intranasal; office type procedure) also would not be appropriate because a medically implanted device (in this case, the button) is not considered a foreign body, unless the device has become detached and poses a threat to the patients well-being.

Instead, use an appropriate-level office visit code (99201-99205 new; or 99211-99215, established) for the septal button removal. This procedure is unlikely to affect the overall level because it should not increase the history, examination or medical decision-making components of the visit.


Answers to You Be the Coder and Reader Questions provided by Barbara Cobuzzi, MBA, CPC, CPC-H, an otolaryngology coding and reimbursement specialist and president of Cash Flow Solutions in Lakewood, N.J.; Lee Eisenberg, MD, an otolaryngologist in private practice in Englewood, N.J., and a member of CPTs editorial panel and executive committee; Susan Callaway, CPC, CCS-P, an independent coding and reimbursement specialist and educator in North Augusta, S.C.; and Ann Hughes, CPC, a practice coder with Mid-Vermont ENT in Rutland, Vt.