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How would you code turbinates coblation, superficial nasal cautery & nasal endoscopy

  1. #11
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    Medical Coding Books
    Quote Originally Posted by lmartirosyan View Post
    I am going to type exactly how it appears on the progress note.
    Nasal Endoscopy
    Rigid video nasal endoscopy with playback
    Septum ulcerated to the left samll active bleeding (does it qualify for 31238?)Inferior turbinates erythema , Nasopharynx no lesions or excessive mucous
    Would you code this as 31231 or 31238

    this one to me, is a diagnostic 31231, I don't see in the above mentioned note where he cauterized the small active bleeding while in there, separate procedure in my opinion


    Also,

    Turbinates Coblation
    Nose was decongested with neosynephrine sprays followed by injection into each turbinate. Reflex wand 45 (isn't this for turbinate resection) was inserted into each turbinate for 20 seconds per pass.
    Is this 30801 or 30140?
    this one to me, is a 30801 - again, I don't see "resection" of anything.

    Nasal cautery
    Topical anestheisa applied with lidocaine and epinephrine. Epistaxis controlled using suction cautery, superficial elecrocautery of bleeding turbinates were performed, after local anesthesia with pontocaine/afrin. Pt tolerated well.
    this one to me is, still a 30801 due to the turbinates cautery -

    Is this "nasal cautery" included in 30801, {I believe the above "nasal cautery" is a 30801 and wouldn't code the 3090x codes} or I have to code from 30901-30905. It does not specify Anterior simple, complex or posterior initial or subsequent?
    30901-30905 are control of less serious nose bleeds/ 30905 for bleeding that is coming from the back of the nose/30906 for subsequent

    So, the overall codes.
    Would you code 31231-51 and 30801??
    {the above is how I'd code it also}
    Thanks a bunch for all your replies.
    {that's my opinion on the posted matter}
    Donna, CPC, CPC-H

  2. #12
    Location
    Woodland Hills, CA
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    Thank you, thank you, thank you!
    I appreciate your help. :-))))))
    CPC CCS
    "The true way to render ourselves happy is to love our work and find in it our pleasure."

  3. #13
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    Woodland Hills, CA
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    Amit,
    I respect your opinion too. I am sorry, but I agree with Donna.
    Sorry about that and thank you very much for your time.
    Last edited by HCCCoder; 08-19-2008 at 09:13 AM.
    CPC CCS
    "The true way to render ourselves happy is to love our work and find in it our pleasure."

  4. #14
    Location
    Woodland Hills, CA
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    Hello all,
    I just came across another one, that doctor does not specify if the nasal cautery was superficial (30801) or intramural (30802). This is how it appears:
    Turbinate Coblation
    Appropriate consent was obtained.
    Nose was decongested with neosynephrine sprays.
    Followed by injection with lidocaine to each turbinate.
    Reflex wand 45 was inserted into each turbinate.

    Nasal Cautery- epistaxis controlled using silver nitrate sticks. The procedure was tolerated well.

    Would you code this scenario as 30801 or 30802?
    Or maybe I should deny because of not having enough documentation (unfortunately, can't interact with the physician).
    Does anybody know, what "silver nitrate stick" is about? When they use this, which procedure you can code 30801 or 30802?

    Thanks a lot to all of those who will respond.
    Lilit
    CPC CCS
    "The true way to render ourselves happy is to love our work and find in it our pleasure."

  5. Default How would you code turbinates coblation, superficial nasal cautery & nasal endoscopy
    In review of CPT Code 31238:
    The physician uses and edoscope for a diagnostic evaluation of the bleeding nose. An endoscope has a rigid fiberoptic telescope that allows the physician both increased visualization and magnification of internal anatomy. Topical vasoconstrictive agens are applied to the nasal mucosa and nerve blocks with local anesethesia are performed. The endoscope is placed into the nose and a thorough inspection of the internal nasal structures is accomplished. Any bleeding sources are identified. Electrocautery instruments or laser are placed parallel to the endoscope and are used to stop internal nasal bleeding.

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