30140 vs 30802 medical review denials

cwater

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Is anyone having CPT 30140 denied during medical review by Onet for Aetna? We are billing Aetna for CPT 30140 and when Aetna sends the operative notes to Onet for review, Onet denies the 30140 and states that CPT 30802 is supported instead.

CPT 30140

Submucosal resection inferior turbinate, partial or complete, any method

The submucosal resection differs from the excision procedure in that during the submucosal resection the physician will make an “incision” into the turbinate mucosa to expose the underlying turbinate bone. The turbinate bone is excised.

CPT 30802

intramural (ie, submucosal)

The most common type of ablation procedure that we are seeing is the radio-frequency ablation technique. The physician will insert a radio-frequency probe submucosally into the turbinate usually creating 3 channels or tunnels. The heating effect of the radio-frequency probe then helps to shrink the hypertrophied turbinate, reducing it in size.

The section of the operative report relating to this issue is listed below:

Using a coblater to incise mucosa and resect the submucosal soft tissue and bone, SMR of the right inferior turbinate was performed. A tunnel was made between the right bony membranous inferior turbinate. The turbinator was used to remove part of the right bony turbinate with removal of part of the right membranous lateral turbinate membrane

Based on this excerpt from the operative note, how would you code this, 30140 RT or 30802?

Thanks,

Camille Waterhouse
 
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