Pediatric Coding Alert

Question: An established patient reports to the pediatrician after a ball hit her in the face during a soccer match. Her nose is bleeding, and her right eye is blackened. The physician is not able to stop the bleeding with ice or pressure, so she performs repeated and extensive cautery using a silver nitrate stick on both nostrils. The bleeding relents, and the physician orders an x-ray to ensure that the patient's nose is not broken. Results are negative. Notes indicate a level-four E/M. Can I report 30903 x 2, since the physician stopped bleeding in both nostrils? Pediatric Coding Listserv Subscriber Answer: No, you'll report this service under bilateral procedure guidelines. On the claim, report the following codes: • 30903 (Control nasal hemorrhage, anterior, complex [extensive cautery and/or packing] any method) for the repair • Modifier 50 (Bilateral procedure) appended to 30903 to show that the physician treated both [...]