Cpt 30117

SUEV

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Is there something I'm not getting about code 30117? My doc excised a lesion and I was going to use this code but noticed that the RVUs seem extremely high. Could someone tell me if I should be using a different code? Here's the note:

PROCEDURE: The risks and benefits were discussed with the patient and informed consent was obtained. The patient's left nasal cavity was inspected. The papilloma was injected with 1% Lidocaine with 1/100,000 Epinephrine. The lesion was than removed with grasp with forceps and excised with Metzenbaum scissors. The wound base was than cauterized with silver nitrate. The patient tolerated the procedure well.

Thanks for any help!
 

BCrandall

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Why use 30117? Would 30115 be more appropriate? 30117 is for using cryo or laser to remove the lesion, the note doesn't make mention of that...
 

SUEV

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I interpreted the laser, etc to apply to the destruction of the lesion, not the excision portion of the code. I use Encoderpro by Ingenix and when I looked at the code, their illustration uses a scalpel for 30117. A picture's worth a thousand words so I went with that. Then again, it made me uneasy when we finally figured out the price. I had looked at 30110 & 30115 but since those codes specifically refer to polyps, I didn't think I could use those. Would you use them for non-polyp removals?
 

RebeccaWoodward*

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Susan,

I agree with your code... 30117. My software states "The physician removes or destroys a lesion from the inside of the nasal passage. The lesion can be destroyed using a laser, extreme cold or heat, or any other method. Code 30118 if the lesion is accessed through a small incision in the nose."

As for the WORK RVU's,CMS allows 3.2 with a fee (my state) of $677.16. I really don't think that is too unreasonable.
 

BCrandall

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I'm going by my CDR which says "The physician removes or destroys internasal lesions using techniques such as cryosurgery, chemical application or laser surgery" for 30117. 30115 states "Local anesthesia is injected...and polyps are removed with a wire snare...a scalpel or biting foreceps excise smaller polyps."

I suppose the answer lies with wheter the papilloma can be called a polyp. The only difference I find is that a polyp is usually found within mucus and since this was nasal, I would think there would be mucus involved!;)

I would think there's a higher RVU value due to the usage of cryo, chemical or laser removal.
 
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