Clinical Indicators
Inferior Turbinate Surgery

Procedure CPT FUD
Excision turbinate, partial or complete 30130 90
Submucous resection turbinate, partial or complete 30140 90
Cauterization and/or ablation, mucosa of turbinates superficial (separate procedure) 30801 10
Cauterization and/or ablation, mucosa of turbinates intramural (separate procedure) 30802 10

Indications

1. History...required

a) Chronic nasal obstruction due in part to inferior turbinate hypertrophy.
b) Failure of directed medical management with continued nasal symptoms (medications, allergy treatment, and duration of therapy).
c) Failure of medical treatment of rhinitis medicamentosa.
d) Symptoms of obstructive sleep apnea.

2. Physical Examination...required

a) Inferior turbinate description before and after decongestion.
b) Description of nasal anatomy, documenting presence or absence of other intranasal pathology.

3. Tests...optional

a) Allergy evaluation.
b) Rhinomanometry
c) Acoustic rhinometry

Postoperative Observations

1. Bleeding--change gauze dressing as needed.
2. Pain--if severe or worsening.
3. Packing or internal splint optional--is it in desired location?
4. Monitor for toxic shock syndrome.

Outcome Review

1. One Week

a) Healing--Was treatment required for bleeding or infection?

2. Beyond One Month
a) Airway--Is the presenting problem improved?
b) Are there problems with crusting?
c) Are there problems with sinusitis?
d) Are there problems with ozena/atrophic rhinitis?

Associated ICD-9 Diagnostic Codes

375.42 Chronic dacrocystitis
478.0 Hypertrophy of nasal turbinates
780.53 Hypersomnia with obstructive sleep apnea

Additional Information
Assistant Surgeon -- N
Supply Charges -- N

Anesthesia Code(s)
00160

Patient Information
Turbinate cauterization involves treatment of a portion of the membrane of an enlarged inferior turbinate to reduce its size. Partial turbinate resection involves removal of a portion of bone and sometimes the mucous membrane of an enlarged inferior turbinate. It is a safe and effective procedure to relieve nasal congestion which has not improved with treatment of other underlying nasal, sinus, and/or allergy problems. Inferior turbinate procedures are performed under local or general anesthesia, sometimes employing cautery, laser, cryotherapy or radio frequency ablation. They may be performed in association with other nasal and or sinus procedures. Post-operative bleeding may occur. Nasal sprays and lubrications may be prescribed to relieve dryness and aid in healing. Long term complications that may be associated with turbinate surgery include bleeding, crusting, dryness, odor, scarring, and sinusitis.

Important Notice

The Clinical Indicators for Otolaryngology--Head and Neck Surgery are guidelines only. In no sense do they represent a standard of care. The applicability of an indicator for a procedure, and/or of the process or outcome criteria, must be determined by the responsible physician in light of all the circumstances presented by the individual patient. Adherence to these guidelines will not ensure successful treatment in every situation. The American Academy of Otolaryngology-Head and Neck Surgery, Inc. emphasizes that these clinical indicators should not be deemed inclusive of all proper treatment decisions or methods of care, nor exclusive of other treatment decisions or methods of care reasonably directed to obtaining the same results.

© 2000 American Academy of Otolaryngology-Head and Neck Surgery. One Prince Street, Alexandria, VA 22314.