Otolaryngology Coding Alert

Question: An otolaryngologist performs a septoplasty, submucous resection of inferior turbinates, and open reduction and internal fixation of nasal fracture. The surgeon states that he performed septoplasty for the cartilage. The nasal fracture reduction and fixation treated the severe deformity and the inability to breathe. How should we bill the procedures?Louisiana SubscriberAnswer: You should report two of the three surgeries: the turbinate resection (30140, Submucous resection turbinate, partial or complete, any method) and the fracture treatment (21330, Open treatment of nasal fracture; complicated, with internal and/or external skeletal fixation).Do not bill the septoplasty (30520, Septoplasty or submucous resection, with or without cartilage scoring, contouring or replacement with graft). The National Correct Coding Initiative bundles the septoplasty (30520) with the nasal fracture treatment (21330). Medicare considers reshaping the nasal septum part of the fracture treatment.No Medicare edits exist for the turbinate resection (30140) and the fracture treatment (21330). Coders, have, however, [...]