Q: Is it appropriate to bill for resection of a concha bullosa with other turbinate procedures?
A: Yes, under certain circumstances which require a detailed review of the operative note. It is important to remember these elements:
If the surgeon performs CPT 31240 with CPT 30130 or CPT 30140 on the same (or opposite) side(s), both are billable. Modifier -59 should not be necessary but could be appended if needed to over-ride inappropriate bundles.
Many third party payers inappropriately bundle endoscopic concha bullosa resection with the turbinate excision or submucous resection codes. This occurs if the insurer does not realize that the procedures were performed on separate turbinates. These procedures are not bundled in the National Correct Coding Initiative (NCCI) edits. You should appeal denied claims for turbinate surgery when your operative notes adequately document separate procedures.
Revised April 2009
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