Wiki 30930

[Earnose]

Can CPT code 30930 be billed bilaterally?

 

[RebeccaWoodward*]

Yes. It has a payment status indicator of 1

1=use mod 50 if bilateral

 

[jgf-CPC]

Good question. This is one of the reasons the AMA continues to try to make the language consistent in the CPT book. In this case, the (s) on “turbinate(s)” refers to one or all three turbinates on the same side (superior, middle and/or inferior). Thus, the code is a unilateral code and may be reported twice if the physician performs turbinate surgery on both sides of the nasal cavity. Hope this helps.

 

[Earnose]

Thank You! My doctor would bill everything bilateral if he could.
So he did a surgery today and here is what he billed is this correct.
30520
30802 ,59 (he would love for this to be bilateral)
30930,59,50

Thank You

 

[jackjones62]

Unfortunately I beg to differ, CPT indicates 30930 is Fracture of nasal INFERIOR turbinate(s), it should NOT be billed bilaterally; we only have 2 inferior turbinates, one on the right and one on the left, the (s) is the indicator.

Jennifer
ENT CT

 

[RebeccaWoodward*]

Per CPT Assistant July 2001


Respiratory System, 30930 (Q&A)

Question

If therapeutic fracture of turbinates is performed bilaterally, should modifier -50, Bilateral Procedure, be appended to code 30930, Fracture nasal turbinate(s), therapeutic, or is code 30930 inherently bilateral?

AMA Comment

From a coding perspective, code 30930 is a unilateral code. Therefore, if therapeutic fracture of nasal turbinates is performed bilaterally, modifier -50 should be appended.

Again...CMS has a payment indicator of....

Bilateral Surgery (50) 1 = 150% payment adjustment for bilateral procedures applies.

 

[RebeccaWoodward*]

Unfortunately I beg to differ, CPT indicates 30930 is Fracture of nasal INFERIOR turbinate(s), it should NOT be billed bilaterally; we only have 2 inferior turbinates, one on the right and one on the left, the (s) is the indicator.

Jennifer
ENT CT

And....

Question:
CPT code 30930 confuses me. The code says “turbinate(s)”. Do I report this code bilaterally using a -50, or does the (s) mean that it is a bilateral code?

Answer:

Good question. This is one of the reasons the AMA continues to try to make the language consistent in the CPT book. In this case, the (s) on “turbinate(s)” refers to one or all three turbinates on the same side (superior, middle and/or inferior). Thus, the code is a unilateral code and may be reported twice if the physician performs turbinate surgery on both sides of the nasal cavity.

If we look at the Medicare fee schedule, we will see there is a number 1 in the fee schedule definition. This means that the 150% payment adjustment for a bilateral procedure applies, meaning Medicare would pay for a bilateral procedure according to their normal payment policy


http://www.karenzupko.com/resources/codingcoach/cc_otoarchive_2006.html

 

[ndejesuscpc]

30930 is a unilateral code. In my practice it is billed and paid as such. So the Modifiers LT, RT, or 50 should be appended.

 

[jackjones62]

30930 uni/bi?

Rebecca and all contributors,
Thank you for your information re: CPT 30930; after I disagreed, I started to do some research as CPT 30930 is one of those codes that when I was taking my Coding class, it stuck out....I have been certified since 2002 and prior to that I had been to Karen Zupko's coding conferences several times in the early 2000's...turbinate coding has always been questionable...but in your response, you indicated that the (s) on “turbinate(s)” refers to one or all three turbinates on the same side (superior, middle and/or inferior), my argument was this, in 2006 the language changed from "Fracture nasal turbinate(s)" to "Fracture nasal INFERIOR turbinate(s); this language cancels out the ability to bill bilaterally; so the language is not consistent as we only have 2 inferior turbinates, one on the right and one on the left. I can fully appreciate that Medicare and other carriers will pay this as bilateral and plan to bill as such, but certainly I am not alone in my understanding of the language used.

I just wanted to thank you for your input and information, I learn new things every day and the Forum is definitely appreciated.

Jennifer
CT ENT

 

[RebeccaWoodward*]

Jennifer,

I completley understand your view. There are many, many coding conventions/guidelines that seem conflicting to me as well. I'm glad you're on this forum. Your insight has been very, very helpful!