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Thread: Open Red NSFX and Submucous Resection

  1. #1
    Join Date
    Apr 2007

    Default Open Red NSFX and Submucous Resection

    AAPC: Back to School
    My ENT Physician wants to bill 21335 and 30140. The ENT Physician states these are two seperate locations. The arugument is the hypertrophy of the turbs will not automatically correct itself after the treatment of the nasal fx. The physician states these are two seperate incision sites and both have a specific medical necessity.

    Naturally when we bill these two codes we have to use modifier 59. Insurance companies are still denying. Any suggestions or related documentation to present to the physician in regards these two procedures shouldn't be billed together or when they could be billed together?

    Thank You!

  2. #2
    Join Date
    Apr 2007

    Default Phyllis Urinoski, CPC

    You need to check your CCI edits. 30140 is a component of 21335.

  3. #3
    Join Date
    Apr 2007


    I did check them and you can bill with a -59. I was wondering if someone can tell me or instruct me to some type of documentation on when it would be appropriate so i could forward to my physician.

    thank you

  4. #4
    Join Date
    Apr 2007


    Did you try a letter of appeal to the insurance carrier with a copy of the opertative note?
    Tammy L. Coleman, CPC

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