30520 with 30140

[coderguy1939]

Anyone have some definitive information regarding using these codes together. CCI allows it, AMA does not. Thanks.

[dmaec]

coderguy1939 - the way I read the codes is: for 30410 it's to reshape the external nose. No surgery to the nasal septum is necessary.
30520 - is to reshape the nasal septum, correcting airway obstruction.
It seems that 30520 is more extensive and would include reshaping the nose a bit due to the reshaping of the septum, etc.
not sure why the CCI edits and notes in AMA differ.... but, I would code only the 30520 if they reshaped the septum and the nose. If they reshaped ONLY the external nose, I'd use 30410.
{my opinion}

[Treetoad]

I would tend to agree with Donna. It would seem to me that since the septoplasty is more extensive, it would include the re-shaping as well. Maybe there are other coders out there who can share their opinions also?

[coderguy1939]

Second code is 30140 Submucous Resection of Turbinates not 30410.

[dmaec]

sorry about the code mix up coderguy1939!! in that case - as I review the codes again - AMA doesn't "not allow" it - it's just pointing you in the direction for another code if "more" was done. AMA doesn't say "do not report 30140 with 30520" it's just telling you that for submuccus resection of the nasal septum, use 30520.
oh, and that's why CCI edits say it's ok too! (I was looking at the correct code there!)

again,
{just my understanding/opinion on the posted matter}

[mbort]

I frequently code the 30520 w/30140. Under the instructions for 30520 it states "excludes turbinate reduction 30140. Have you been having problems with billing these two codes together?

[dmaec]

the instructions in my cpt under 30520 simply states (for submuccous resection of the turbinates, use 30140)

which CPT manual do you use mbort?
thanks

[mbort]

my hard copy CPT states the same as yours, however my Encoder Pro has that as an instruction as well (. I've copied and pasted for review..all the way at the bottom:


30520
Septoplasty or submucous resection, with or without cartilage scoring, contouring or replacement with graft

Lay Description

The physician reshapes the nasal septum, correcting airway obstruction. Topical vasoconstrictive agents are applied to shrink the blood vessels and local anesthesia is injected in the nasal mucosa. The physician makes a vertical incision in the septal mucosa and elevates the mucoperichondrium from the septal cartilage. The deviated portion of the bony and cartilaginous septum is excised or augmented by grafting. Local grafts from adjacent nasal bones and cartilage are not reported separately. If the cartilaginous septum remains bowed, partial or full-thickness incisions are made in the cartilage to straighten the septum. Excess cartilage is excised from the bone-cartilage junction. Incisions are closed in single layers. Transseptal sutures are placed. Septal splints may support the septum during healing.







Notes

Section Notes - Repair - (30400-30630)
(For obtaining tissues for graft, see 20900-20926, 21210)






Code-Specific Reference Information

Instructions
AMA CPT® Assistant References





Instructions

Excludes turbinate resection (30140)

[dmaec]

yes, I miss having a good encoder! hopefully my supervisor wins the battle and we'll have 3M soon.

thanks!

[coderguy1939]

Thanks for your help.