Otolaryngology Coding Alert

Question: When billing for physician services, our practice always follows the National Correct Coding Initiative (CCI) Edits' rule on 30802 being bundled into 30930 in the same surgical session. However, our surgery center bills both codes together, and switches back and forth in their billing policy, depending on which edit a payer follows. What is  the general rule on this?

Massachusetts Subscriber

Answer: Irrespective of bundling rules, the practice should not bill multiple turbinate procedures on the same side of the inferior turbinate for payment. A physician in New Jersey almost lost his license because he billed multiple turbinate codes and they were not bundled at the times. You can only bill for the most extensive procedure you do the turbinate on each side. Think of gastric endoscopies and how you can only bill for the most extensive endoscopy or colonoscopy.

CPTs 30802 (Ablation, soft tissue of inferior turbinates, unilateral or bilateral, any method [e.g., electrocautery, radiofrequency ablation, or tissue volume reduction]; intramural [i.e., submucosal]) and 30930 (Fracture nasal inferior turbinate[s], therapeutic) apply to the inferior turbinate(s), along with these codes:

• 30130 -- Excision inferior turbinate, partial or complete, any method;
• 30140 -- Submucous resection inferior turbinate, partial or complete, any method;
• 30801 -- Ablation, soft tissue of inferior turbinates, unilateral or bilateral, any method [e.g., electrocautery, radiofrequency ablation, or tissue volume reduction]; superficial.