Wiki Swell Body and Turbinate Reduction UHC Coding

[wsandner]

Needing some guidance on how I would bill Bilateral excision and ablation of septal swell body lesions (30117) and Bilateral inferior turbinate Submucous resection (30140) for UNITED HEALTHCARE. Would I need to change any units per line item on the swell bodies or include any RT/LT, XS, 59 or XS modifiers? Any examples would be so helpful, thank you in advance!

 

[b.cobuzzi]

You cannot code 30117 with a 50 modifier per the medicare fee database. So the second side needs to be coded with an XS and I would include RT and LT for each side. Are you sure that a submucous turbinate reductions was actually performed. Surgeons use Vivaer to destroy the nasal swell bodies and they use the same Vivaer handpiece to do a submucous turbinate destruction. The turbinate reduction is via radiofrequency. And although it is submucosal, the low temperature radiofrequency achieves the submucosal "reduction" or shrinkage of the turbinate, but there is no incision into the submucosa. So, 30801 is the best code for this procedure. In order to bill 30802, an incision into the submuco9sa and placement of the wand into the submucosa is required for the shrinkage of the turbinates.