Kevinph84
Guest
I have two cases that has me confused. Both cases were done for acquired nasal deformities causing obstruction, secondary to trauma.
Case # 1
Provider Performed:
1.) ORIF Nasal Septal Fractures
2.) Reconstruction of Nasal Tip using Tip and Columella Graft
3.) Reconstruction of Middle Vault on the Left with Spreader Grafts
4.) Correction of Dorsal Deformity with Radix Graft
5.) Lateral Fracture and Cauterization of Inferior Turbinates
6.) Reduction of Right Middle Turbinate
Case # 2
Provider Performed:
1.) ORIF Nasal Septal Fractures
2.) Correction of External Vault using Tip and Columella Graft
3.) Reconstruction of Middle Vault on the Left with Spreader Grafts
4.) Insertion of Radix Graft
5.) Lateral Fracture and Cauterization of Inferior Turbinates
The other party is billing the above cases as 21335, 30465, and 20912 x2
I feel 30930 applies for the outward fracturing on the turbinates. I am torn between coding procedures 30520 (septoplasty) and 30420 (Rhinoplasty, primary, including major septal repair). I do not feel all the grafting is appropriate to bill because both of these codes include the grafting. Also both codes include 21335. Now 30520 does fall into 30420. I'm not sure which one is more appropriate. Does anyone have an idea? Thank you all for your help.
Case # 1
Provider Performed:
1.) ORIF Nasal Septal Fractures
2.) Reconstruction of Nasal Tip using Tip and Columella Graft
3.) Reconstruction of Middle Vault on the Left with Spreader Grafts
4.) Correction of Dorsal Deformity with Radix Graft
5.) Lateral Fracture and Cauterization of Inferior Turbinates
6.) Reduction of Right Middle Turbinate
Case # 2
Provider Performed:
1.) ORIF Nasal Septal Fractures
2.) Correction of External Vault using Tip and Columella Graft
3.) Reconstruction of Middle Vault on the Left with Spreader Grafts
4.) Insertion of Radix Graft
5.) Lateral Fracture and Cauterization of Inferior Turbinates
The other party is billing the above cases as 21335, 30465, and 20912 x2
I feel 30930 applies for the outward fracturing on the turbinates. I am torn between coding procedures 30520 (septoplasty) and 30420 (Rhinoplasty, primary, including major septal repair). I do not feel all the grafting is appropriate to bill because both of these codes include the grafting. Also both codes include 21335. Now 30520 does fall into 30420. I'm not sure which one is more appropriate. Does anyone have an idea? Thank you all for your help.