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Otolaryngology Coding Alert

READER QUESTIONS:

Modifier 52 Helps Describe Resection, Outfracture

Published on Sun Mar 01, 2009

Question: I have a physician who wants to bill both 30140 and 30930 during the same surgical session. He had our clerk bill both these on several claims and insurances have paid both. My feeling is we should not be billing for both the submucosal resection and outfracture. When I look at 30930, there is no Correct Coding Initiative edit for billing with 30140, but if you look at 30140, the CCI edit is there for 30930. Can you explain why we should or should not bill these together? Minnesota Subscriber Answer: If bone is outfractured but not removed and submucosal tissue is removed, you would append modifier 52 (Reduced services) to 30140 (Submucous resection inferior turbinate, partial or complete, any method); that code would properly describe reduction of turbinates. To bill 30140, the mucosa must be incised, and the bone cut out and removed from the mucosa, leaving the [...]
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