Q. What are the appropriate codes to report when a physician performs a superficial radiofrequency ablation at the same session as out-fracturing both inferior turbinates?
A. You cannot report this procedure with CPT code 30930-Fracture nasal inferior turbinate(s), therapeutic, because of an existing National Correct Coding Initiative (NCCI) edit (often referred to as a code bundle). However, if an intramural radiofrequency ablation is performed, 30802-Cautery and/or ablation, mucosa of inferior turbinates, unilateral or bilateral, any method; intramural may be reported, appending the -59 modifier-distinct procedural service. Report each CPT code only once since the descriptor states each is a bilateral service. This guidance applies to Medicare and most carriers that apply NCCI edits to their payment policy; carriers may, however, vary in their application of NCCI and other code edits.
Approved May 2009
Important Disclaimer Notice (Updated 8/7/14)
CPT for ENT articles are a collaborative effort between the Academy’s team of CPT Advisors, members of the Physician Payment Policy (3P) workgroup, and health policy staff. Articles are developed to address common coding questions received by the health policy team, as well as to clarify coding changes and correct coding principles for frequently reported ENT procedures. These articles are not intended as legal, medical, or business advice and are not a guarantee of reimbursement. The information is also not meant to serve as the definitive or sole authority on billing and coding issues. The applicability of AAO-HNS billing and coding guidance for a particular procedure, must be determined by the responsible physician in light of all the circumstances presented by the individual patient. You should consult with your own advisors as well as Medicare or private carriers in making any decisions about how to bill and code particular services or procedures.