Otolaryngology Coding Alert

You Be the Coder :

Settle This Debate Over Resection Vs. Coblation

Question: One of my docs says this is a submucous resection turbinectomy. The op report reads: Stab incisions were made in the anterior edge of the inferior turbinates bilaterally. Submucous resection of the inferior turbinates was carried out bilaterally with coblation wand including a series of six tack lesions, three superior and three inferior in the anterior edge of the inferior turbinates bilaterally. The turbinate rims were then outfractured with a Sayre elevator. I am not sure that when my physician uses the coblation wand, we can code this as an SMR.

Pennsylvania Subscriber

Answer: This is definitely a radiofrequency procedure, not a resection. Your physician is shrinking tissues with radiofrequency, therefore you have a choice of 30802 (Cautery and/or ablation, mucosa of inferior turbinates, unilateral or bilateral, any method; intramural) or 30999 (Unlisted procedure, nose). But it is definitely not 30140 (Submucous resection inferior turbinate, partial or complete, any method).

The Academy of Otolaryngology Head and Neck Surgery has a policy on radiofrequency ablation of turbinates on its Web site. Find it at www.entnet.org/Practice/upload/Radio-Frequency-Ablation-coding-2008-2.pdf.

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