Coding for RFA of the Turbinates

Q: How should I code for radiofrequency ablation (RFA) techniques?

A: In evaluating the most appropriate CPT code to use for radiofrequency techniques, it is important to remember that CPT coding guidance requires that physicians not select CPT codes that merely approximate the services provided. If no such code exists, report the service furnished using the appropriate unlisted procedure code.

Radiofrequency ablation is a surgical technique used in the destruction of tissue. It is generally associated with lower temperatures than those of electrocautery. Radiofrequency devices may be used to ablate tissue or as actual cutting tools (e.g., for tonsillectomy). You should select procedure codes based on precise manner by which the device was used.

Radiofrequency for base of tongue

In 2009, there is a new Category I code to describe  RFA of the base of the tongue, CPT code 41530 -Submucosal ablation of the tongue base, radiofrequency, one or more sites, per session. The previous category III code 0088T Submucosal radiofrequency tissue volume reduction of base of tongue, one or more sites, per session (i.e., for treatment of obstructive sleep apnea syndrome) has been deleted.

Radiofrequency for the palate or uvula

For RFA of the palate, uvula, use CPT 42299-Unlisted procedure, palate, uvula. According to CPT guidelines, it is inappropriate to report any other CPT code to describe RFA of the palate or uvula. In this instance, the use of CPT code 42145 is incorrect.

Radiofrequency of the inferior turbinates

When coding RFA of the inferior turbinates, consider the precise nature of the procedures. CPT codes 30801 and 30802 were editorially changed in 2010. CPT code 30802 Ablation, soft tissue of inferior turbinates, unilateral or bilateral, any method (eg, electrocautery, radiofrequency ablation, or tissue volume reduction; intramural (ie, submucosal) is the ablation or cauterization of the depper mucosal solt tissue. CPT code 30801 Ablation, soft tissue of inferior turbinates, unilateral or bilateral, any method (eg, electrocautery, radiofrequency ablation, or tissue volume reduction; superficial is ablation or cauterization which involves only the surface layer of the inferior turbinate mucosa. From the perspective of physician work, RFA in these clinical situations does not differ significantly from the use of uni- or bi-polar electrocautery. Thus, CPT guidelines require each of these methods of cautery/ablation to be reported in the same fashion, just as one would with tonsillectomies performed by various methods (eg, electrocautery, laser, dissection with surgical instruments). Only if the RF device were used to incise mucosa and resect submucosal soft tissue and/or bone, should CPT 30140 Submucous resection inferior turbinate, partial or complete, any method be reported.

Radiofrequency of the middle or superior turbinates

Use CPT code 30999-Unlisted procedure, nose to report radiofrequency used on the middle or superior turbinates.

Revised May 2009

Revised February 2008

Revised June 2012

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