Balloon Septoplasty

calexander1265

Networker
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47
Location
Raliegh North Carolina
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What is the correct procedure code when billing for a Balloon Septoplasty? I have been told 30520 since it is correcting the deveated Septum and no other procedure is performed.

Thank you
 

jackjones62

Expert
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252
Location
Niantic, CT
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Hi There, Not sure if anyone responded, sorry I did not see this earlier. Billing 30520 is inappropriate for a Balloon Septoplasty, you should be utilizing 30999 Unlisted Procedure of the Nose. A traditional septoplasty is an invasive procedure with an incisional approach, cartilage removal and/or grafting, and suturing techniques all done to repair a deviated septum, a balloon septoplasty is not invasive, does not require the same type of skill or involve the same type of risk or liabilty, and it takes minimal time.

Be sure to submit a supplement "Special Report" with your claim, as well as a comparative CPT code such as a Sinuplasty code.

Hope this helps!

Jennifer
Coding Analyst
(28 yrs - ENT)
 

b.cobuzzi

Guru
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From the article in Oto Coding Alert in Feb 2020:

The last piece in the coding puzzle is determining what existing code is most similar to the septoplasty with balloon dilation. Submitting an existing reference code alongside an unlisted code is important for contextual purposes. “It is recommended that you report a comparison code of 31295 [Nasal/sinus endoscopy, surgical, with dilation (eg, balloon dilation); maxillary sinus ostium, transnasal or via canine fossa] if the surgeon uses one balloon,” advises Barbara J. Cobuzzi, MBA, CPC, COC, CPC-P, CPC-I, CENTC, CPCO, of CRN Healthcare in Tinton Falls, New Jersey. “If the surgeon uses two balloons, you should also equate 30999 to 31295, except with modifier 50 appended,” says Cobuzzi.
 
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