modifier 50 on cpt 30930

bench

Networker
Messages
80
Best answers
0
I need your opinion please. In the cpt book, cpt code 30930 FRACTURE NASAL INFERIOR TURBINATE(S), THERAPUTIC. I was claiming this procedure and added mod 50 since it was done both sides. Anthem Blue Cr. said this is not claimable under MOD 50 because the cpt book already stated it as a plural. Do you believe this? In the CCI edits, this is claimable with mod 50 or lt/rt. Since Bluc Cr. doesn't follow the CCI edits this is the reason they returned to us.
 

mbort

True Blue
Messages
2,338
Location
ENGLEWOOD/DENVER
Best answers
0
per cpt asst, this is a unilateral code. Here is the documentation to help support your appeal:


Year: 2001

Issue: July

Pages: 11

Title: Respiratory System, 30930 (Q&A)

Body: Coding Consultation

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.


© 2005 American Medical Association
 
Top