Ambs0816
New
Our rhinologist has started doing this procedure and I am having trouble assigning a code, the description of the procedure is:
I began by removing the Rhino Rocket that had been placed in the emergency department. I then removed a lot of crusting and found a large septal perforation with clean edges suggesting that the perforation is longstanding. I then identified the largest telangiectasias that seems to be the source of the bleeding and I ablated them with a combination of a Coblator and a suction Bovie. This was performed on the left and right sides with the left side being more involved. There were some fairly substantial areas of bleeding on the floor of the nose with large carpet like areas of telangiectasias. The patient's nasal cavities were then irrigated and found to be hemostatic. I placed some fibrillar high up in the nose bilaterally and put a layer of Surgi-Flo along the floor and superiorly in the nose. I then packed the nose with some Nasapore.
I am going between - 31238 Nasal/Sinus endoscopy, surgical, with control of nasal hemorrhage, 30801/30802 Ablation, soft tissue of inferior turbinates, 30117 Excision or Destruction, intranasal lesion or do I just go Unlisted and compare to one of these codes for reimbursement. I feel like I have looked at every possible option so any ideas or help would be greatly appreciated
I began by removing the Rhino Rocket that had been placed in the emergency department. I then removed a lot of crusting and found a large septal perforation with clean edges suggesting that the perforation is longstanding. I then identified the largest telangiectasias that seems to be the source of the bleeding and I ablated them with a combination of a Coblator and a suction Bovie. This was performed on the left and right sides with the left side being more involved. There were some fairly substantial areas of bleeding on the floor of the nose with large carpet like areas of telangiectasias. The patient's nasal cavities were then irrigated and found to be hemostatic. I placed some fibrillar high up in the nose bilaterally and put a layer of Surgi-Flo along the floor and superiorly in the nose. I then packed the nose with some Nasapore.
I am going between - 31238 Nasal/Sinus endoscopy, surgical, with control of nasal hemorrhage, 30801/30802 Ablation, soft tissue of inferior turbinates, 30117 Excision or Destruction, intranasal lesion or do I just go Unlisted and compare to one of these codes for reimbursement. I feel like I have looked at every possible option so any ideas or help would be greatly appreciated