Wiki 30901 nose bleed repair

[lduquette]

The doctor I bill for used cauterization to stop a nosebleed, she also performed a separate e/m.
When billing Humana I used the 99214>25 and the 30901. The 99214 was paid, but the 30901 was denied as needing the proper code.

I can't find anything on what code it needs. Any help?

 

[Pam Warren]

30901 is a 'minor procedure' with 0 global days. The E&M is bundled into the procedure, per CCI edits:

If a procedure has a global period of 000 or 010 days, it is defined as a minor surgical procedure. In general E&M services on the same date of service as the minor surgical procedure are included in the payment for the procedure. The decision to perform a minor surgical procedure is included in the payment for the minor surgical procedure and should not be reported separately as an E&M service.

Unless the E&M visit was significantly more work than the eval for the cautery, or for another diagnosis code, both will not be paid. So if your diag for both CPT codes was the same, that's why only the E&M paid.