Otolaryngology Coding Alert

Teach staff this rule: 1 turbinate = 1 code The feds and local authorities are cracking down on billing multiple inferior turbinate procedures. Take this quiz to make sure your ENT's turbinate coding would withstand the scrutiny.

An otolaryngologist almost lost his license for billing multiple turbinate procedures, says Barbara J. Cobuzzi, MBA, CPC, CPC-H, CPC-P, CHCC, president of CRN Healthcare Solutions, a coding and reimbursement consulting firm in Tinton Falls, N.J. CPT 2006 instated several previously unprinted bundling issues that are critical to your practice's coding compliance. Take a few moments to review the 2006 turbinate coding changes so you don't carry any dangerous coding mistakes into 2007. Accurately Identify Inferior Turbinate Procedures Question 1: On which turbinates does an ENT perform 30130-30140, 30801-30802 and 30930?

Answer 1: These codes all apply to the inferior turbinate(s). Don't forget: CPT 2006 revised codes:

- 30130 -- Excision inferior turbinate, partial or complete, any method

- 30140 -- Submucous resection inferior turbinate, partial or complete, any method

- 30801 -- Cautery and/or ablation, mucosa of inferior turbinates, unilateral or bilateral, any method; superficial

- 30802 -- - intramural

- 30930 -- Fracture nasal inferior turbinate(s), therapeutic.
 
Big change: -Prior to January 2006, CPT did not specifically differentiate the turbinates,- writes Richard Waguespack, MD, AMA CPT panelist and chair, in the article -Revised 2006 Turbinectomy Guidance- published by the American Academy of Otolaryngology -- Head and Neck Surgeons (AAO-HNS). -CPT Codes 30130 and 30140 now refer specifically to the inferior turbinates (as do codes 30801, 30802 and 30930).-

Include Fracture, Destruction in Excision Question 2: Should you bill for multiple same-side turbinate procedures?

Answer: You can bill only one turbinate procedure per turbinate, Cobuzzi says. Because excision, cautery/ablation and fracture codes all apply to the inferior turbinate, you should report only one of these procedure codes per side.

Example: An otolaryngologist performs submucous resection of the inferior turbinates using laser and the2-millimeter microdebrider and bilateral outfracture of the inferior turbinates.

Code it: You should report this session with 30140. CPT considers the fracture (30930) inclusive in 30140. -Do not report 30130 or 30140 in conjunction with 30801, 30802, 30930,- states the AMA in the parenthetical instruction following 30140.

This note was added in the CPT 2006 manual at the same time that -separate procedure- was removed from the descriptors of 30801, 30802, 30930. Rationale: -Cross-references were added in support of these revisions to indicate 30130 and 30140, which report larger procedures for which removal of the inferior turbinates are [...]