Otolaryngology Coding Alert

Question: Our provider just began performing RhinAer™ for bilateral treatment of chronic nasal drip. Is there an existing code for this procedure, or should I resort to coding with an unlisted option?

Utah Subscriber

Answer: RhinAer™, having just recently received FDA clearance, should become a staple in many otolaryngology practices for treatment of chronic runny nose and nasal congestion. Instead of resorting to past surgical approaches that involve cutting the vidian nerve (with the potential for serious side effects), RhinAer™ destroys the posterior nasal nerves while leaving the vidian nerve intact. Furthermore, RhinAer™ does not require the use of cryoablation to destroy the posterior nasal nerves, resulting in fewer and milder side effects than its more invasive surgical counterpart.

Fortunately, you’ve got an existing CPT^® code that fully encompasses the surgical work included in RhinAer™. In addition to reporting code 30117 (Excision or destruction (eg, laser), intranasal lesion; internal approach), your only subsequent consideration is laterality. Since 30117 has a bilateral surgery indicator of “0,” you may not append modifier 50 (Bilateral Procedure) for when the surgeon performs the procedure bilaterally. Instead, you’ll have to submit 30117 on separate lines, with either modifier XS (Separate structure, a service that is distinct because it was performed on a separate organ/structure) or 59 (Distinct Procedural Service), depending on payer preference.