Hi, I need help in coding an op note; these are the procedure codes md performed, 30520,20912,30465,30802,30930,14060-
A left sided hemitransfixion incision was made. Dissection was the performed in the submucoperichondrial and submucoperiosteal plane of the nasal septum. On the left side, a 1cm crossover point was made leaving a 1cm caudal and dorsal strut. Dissection was performed on the right side as well.
The bony cartilaginous junction was separated, the cartilage dissected off the maxillary crest and the cartilage was removed en bloc. Next, there was
a spur posteriorly. This was resected using double-action scissors, and a spur along the floor of the nose was resected using 8mm osteotome.
The hemitransfixion incision was closed with 5-0 gut sutures and 4-0 plain gut on a keith needle was used to appose the mucosal flaps.
Attention was turned tot he repair of the nasal vestibular valve stenosis. A left sided rim incision and a right-sided alar rim incision was made and
dissection was the performed medially and laterally along both alar rim pockets.
Attention was turned to separately on the Mayo stand where 2 separate alar rim grafts were created, beveled medially and laterally on both sides.
the 1st alar rim graft was slid into the alar rim and closed using 5-0 sutures. On the right similarly, the 1st alar rim graft was slid into the pocket and closed using sutures.
Attention was turned to the left sided redundant skin in the vestibule bilaterally. Elliptical incision was made of redundant skin. This left a defect.
A 7x8 mm advancement flap was used to close the defect with formal back cuts. This was closed with fast gut sutures. In addition, the right hand
side similarly as portion of skin was excised with elliptical incision. Formal cuts were created to form an advancement flap 7x8mm. This was closed
with sutures. This constituted the adjacent tissue rearrangement on the right and left of the nasal vestibules.
Next, attention was turned to the turbinates where the Colorado tip needle was inserted into the anterior head of the inferior turbinate. Visible shrinkage
was noted. In addition the right side similarly the needle was inserted into the inferior turbinate and visible shrinkage of turbinate was noted.
Next boises elevator was inserted into the left hand side of the nasal cavity posteriorly to anteriorly. The inferior turbinate was outfractured, and the right hand side similarly was outfractured.
Is 30520 bundled with 20912, also is 30802 bundled with 30930? Also is it appropriate to bill 14060 bilaterally? I need verification and clarification.
thanks to anyone, who can help.
A left sided hemitransfixion incision was made. Dissection was the performed in the submucoperichondrial and submucoperiosteal plane of the nasal septum. On the left side, a 1cm crossover point was made leaving a 1cm caudal and dorsal strut. Dissection was performed on the right side as well.
The bony cartilaginous junction was separated, the cartilage dissected off the maxillary crest and the cartilage was removed en bloc. Next, there was
a spur posteriorly. This was resected using double-action scissors, and a spur along the floor of the nose was resected using 8mm osteotome.
The hemitransfixion incision was closed with 5-0 gut sutures and 4-0 plain gut on a keith needle was used to appose the mucosal flaps.
Attention was turned tot he repair of the nasal vestibular valve stenosis. A left sided rim incision and a right-sided alar rim incision was made and
dissection was the performed medially and laterally along both alar rim pockets.
Attention was turned to separately on the Mayo stand where 2 separate alar rim grafts were created, beveled medially and laterally on both sides.
the 1st alar rim graft was slid into the alar rim and closed using 5-0 sutures. On the right similarly, the 1st alar rim graft was slid into the pocket and closed using sutures.
Attention was turned to the left sided redundant skin in the vestibule bilaterally. Elliptical incision was made of redundant skin. This left a defect.
A 7x8 mm advancement flap was used to close the defect with formal back cuts. This was closed with fast gut sutures. In addition, the right hand
side similarly as portion of skin was excised with elliptical incision. Formal cuts were created to form an advancement flap 7x8mm. This was closed
with sutures. This constituted the adjacent tissue rearrangement on the right and left of the nasal vestibules.
Next, attention was turned to the turbinates where the Colorado tip needle was inserted into the anterior head of the inferior turbinate. Visible shrinkage
was noted. In addition the right side similarly the needle was inserted into the inferior turbinate and visible shrinkage of turbinate was noted.
Next boises elevator was inserted into the left hand side of the nasal cavity posteriorly to anteriorly. The inferior turbinate was outfractured, and the right hand side similarly was outfractured.
Is 30520 bundled with 20912, also is 30802 bundled with 30930? Also is it appropriate to bill 14060 bilaterally? I need verification and clarification.
thanks to anyone, who can help.