Wiki 30117 billing multiple units

[shelli.hester@pehp.org]

I have physician that is billing 30117 x6.
Right nasal side wall x1, left nasal septum x4 and left nasal sidewall x1.
The MUE is 2 but does not allow modifier 50 for bilateral but does allow -LT and -RT or -59. Can they bill 6 units? Or should this only be billed once per side?

 

[hicksmap]

I have physician that is billing 30117 x6.
Right nasal side wall x1, left nasal septum x4 and left nasal sidewall x1.
The MUE is 2 but does not allow modifier 50 for bilateral but does allow -LT and -RT or -59. Can they bill 6 units? Or should this only be billed once per side?

Per CPT Assist
Code 30117, Excision or destruction (eg, laser), intranasal lesion; internal approach, is reported once per surgical session, regardless of the number of nasal swell bodies that are excised or destroyed because the nasal swell bodies are part of the mucosa of the nasal septum, which is a midline structure. Therefore, the use of modifier 50, Bilateral Procedure, with code 30117 is not appropriate. Even though work is performed through both nostrils, all work is still being performed on a midline structure.

 

[freespririt0806]

Some ins will pay 2, we bill 2 lines RT and LT or
30117
30117xs
BC pays only 1

 

[syrobinson]

Medicare does allow 2 MUE, but it doesn't make sense with what the CPT Assist says