Wiki Septectomy CPT code

AN2114

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I posted a previous question about a septectomy for some advice if the info I had was considered enough to bill out for it. I found cpt code 30520 because that is what my coding book said was the code for a septectomy. I noticed online that other codes were mentioned for a septectomy and there wasn't a clear answer on what code is best. So now I'm second guessing if I have the correct code. Does anyone know if 30520 is the correct code for a septectomy? Or is there a better code to use? Or would a septectomy be included in the choanal atresia repair code (30540)? The only thing the doctor says about the septectomy in the report is A microbackbider was used to perform a posterior septectomy to further open the posterior nasopharynx. I also have the whole op report below:

Patient was taken to surgery induced with general anesthesia and intubated. Shoulder roll was placed to provide neck extension. Patient was then properly prepped and draped. Image guidance with medtronic fusion system was set in place and noted to be working appropriately with the patient's CT scan. This was used throughout the procedure. Bilateral nasal endoscopy was performed using a 0 degree endoscope. On the left there was no pathology. On the right there was evidence of membranous and boney choanal atresia. Afrin and epi pledgets were used to decongest the nose and for hemostasis.

Using a navigation suction, the posterior nasopharynx was entered on the right side by popping through the obstructive tissue and then bone. A microdebrider and drill were used to further remove the obstructive tissue and bone and to widen the opening into the nasopharynx. A microbackbider was used to perform a posterior septectomy to further open the posterior nasopharynx. A boise elevator was used to outfracture and lateralize the inferior turbinates. A propel drug eluting stent was placed in the posterior choana/area of septectomy to stent this area open.

At this point the procedure was complete. Any additional bleeders that were encountered were controlled with afrin pledgets. All instrumentation was removed and patient was sent to recovery in satisfactory condition.
 
30520 is not a septectomy, it is a septoplasty. 31237 is for a biopsy, polypectomy or debridement. The doctor is down in the nasopharynx, but there are no other codes for removal of abnormal tissue via endoscope. You might want to code 31237 with a 22 modifier to account to the additional difficulty from the procedure. The MUE (medically unlikely edits( for 31237 is only one a day, so you code this code no matter how many lesions are removed.
 
30520 is not a septectomy, it is a septoplasty. 31237 is for a biopsy, polypectomy or debridement. The doctor is down in the nasopharynx, but there are no other codes for removal of abnormal tissue via endoscope. You might want to code 31237 with a 22 modifier to account to the additional difficulty from the procedure. The MUE (medically unlikely edits( for 31237 is only one a day, so you code this code no matter how many lesions are removed.
Hi Barbara,
My doctor documents he did a bilateral sphenoidotomy and a posterior ethmoidectomy, then to widened the opening further he performed a posterior septectomy. Would I code for the sphenoidotomy & posterior ethmoidectomy 31257-50 (even though he didn't document anterior ethmoidectomy) and add modifier 22 or am I looking at an unlisted code? I wouldn't know how to equate it.
Thank you!!
 
There is no code for a septectomy. You could add a 22 modifier or you could use an unlisted code. I am unsure what it would be equated to in box 19 when you submit the claim so that you can direct the payer to value the septectomy. You may want to ask your surgeon what is the closest surgical code that he or she performs to be equal to this service, Sue. Call me if you would like to discuss further.
 
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