Pediatric Coding Alert

Question: Our insurer's fee schedule amounts for 30300 and 30310 seem very high, and patients' parents often complain about the high cost of these procedures because sometimes we're just using a pair of tweezers to remove an item from the patient's nose. Are we not doing enough to warrant billing these codes?


Missouri Subscriber


Answer: If you're billing 30310 (Removal foreign body, intranasal; requiring general anesthesia) for simple office procedures involving tweezers, you may be upcoding.

Code 30310 requires general anesthesia, which means that the foreign body is probably very far up the patient's nasal cavity or is too large to remove in the office.

In standard cases when the pediatrician uses tweezers in the office to remove the item, you should report 30300 (Removal foreign body, intranasal; office type procedure). If you report 30300, the physician normally did not need to create an incision. This code generally pays more than $200.

Although the relative values that translate into payment for procedures are high, they are historically consistent within the physician pay scale compared to E/M services.