Otolaryngology Coding Alert

Question: How should I code for partial resection of the inferior turbinates? For instance, I inject both the right and left inferior turbinates with local, make an incision on the front of the turbinates with a #15 blade, insert a Xomed XPS shaver turbinate blade through the incision and evacuate (remove) submucosal tissue down to the periostium and then fracture the turbinate. Should I report 30130-50?


Pennsylvania Subscriber


Answer: When you perform -resection- instead of -excision,- you should use 30140-50 (Submucous resection inferior turbinate, partial or complete, any method; Bilateral procedure), not 30130-50 (Excision inferior turbinate, partial or complete, any method). Partial resection falls under 30140, and excision indicates 30130.

You should classify your operative note, which describes incising and entering the mucosa, as 30140. In this procedure, the otolaryngologist enters the mucosa, raises the mucoperiosteum flaps, cuts out the turbinate bone and lays the turbinate mucosa flaps back over the turbinate.

In contrast, an otolaryngologist who performs the lesser procedure of 30130 cuts the bone out, leaving no mucosa and no bone. He preserves nothing and leaves just the stump.

Problem: Although you call the procedure -partial resection,- your documentation doesn't describe removing the turbinate. You instead performed an outfracture plus partial resection -- a partial removal of the turbinate without taking the turbinate out. This procedure is considered a -reduction,- which should be reported as the reduced service 30140-52 (Reduced services) -- or 30140-52-50 for bilateral.