Part B Insider (Multispecialty) Coding Alert
Know What Sinus Surgeries Include
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Question: Is partial excision of the middle turbinate considered a separate procedure or is it included as part of access to the ethmoid sinus?
Answer: The physician usually performs a middle turbinectomy in order to access the sinus structures, include the ethmoid. If the turbinectomy is performed in addition to an ethmoidectomy (31254-31255), you cannot separately report the turbinectomy.
Caveat: If the surgeon performs an endoscopic middle turbinectomy to treat a problem in that area (such as excision of a concha bullosa resection, 31240), you can report both procedures because they are not considered bundled per CCI (Correct Coding Initiative). But many payers do still bundle 31240 with both ethmoidectomy codes and it is difficult to get both codes paid together.
Remember that procedures to the middle also are bundled with maxillary FESS codes. If a physician removes a middle turbinate with a non-ethmoid or maxillary endoscopic code (such as a middle turbinectomy and septoplasty), report the middle turbinectomy as unlisted code 30999 (Unlisted procedure, nose). The middle turbinates were removed froom the existing turbinate code descriptions in 2006
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