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Thread: 30801 included in 30520??

  1. #1
    Join Date
    Apr 2007
    Tulsa, OK

    Default 30801 included in 30520??

    AAPC: Back to School
    We are getting a denial from Aetna showing that cautherization of the inner nose (30801) is included in the repair of nasal septum(30520)...can anyone give me any guidence? When I look up the two codes in my coder's desk reference, it does not say that we do the cautherization with the repair.
    Last edited by philnamba; 12-12-2008 at 01:39 PM.

  2. #2
    Join Date
    Apr 2007
    Salt Lake City

    Smile EvonP

    According to both CCI and Part B edits 30801 is not included in 30520.

    CPT/HCPCS to CCI Code Check
    Code / Description
    30520 REPAIR OF NASAL SEPTUM M Non-Facility RVU: 14.67
    No bundling issues exist
    30801 ABLATE INF TURBINATE, SUPERF M Non-Facility RVU: 5.42
    No bundling issues exist

    Unless Aetna is making their own coding edits and not following CCI/Part B edits ,these codes should not be bundled. I would definately appeal this...maybe call Aetna (or check your contract with them if you can) and ask what coding edits they are using because the industry standard edits (CCI/Part B edits) do not bundle these codes. Good luck!

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