We have a conflict over the correct code for this. 30140 states any method, submucosal resection of inferior turbinate. However some coders state it is any "method" not any approach and that "endoscopic" approach and submucosal resection of inferior turbinates would be best coded 30999.
Resection of Nasal Turbinate, Open Approach. 2016 2017 2018 2019 Billable/Specific Code. ICD-10-PCS 09TL0ZZ is a specific/billable code that can be used to indicate a procedure.
There is only one endoscopic sinus code that involves procedures on the turbinates: 31240, concha bullosa resection. That code would only be used specifically to treat a concha bullosa, and not appropriate for a regular turbinate hypertrophy.
This involves carefully elevating the mucosal lining that overlies the bone of the turbinate and removing the enlarged portions of bone. The lining is then replaced and the remaining bone is pushed outwardly to enlarge the nasal airway. It is important to remember that the inferior turbinates play an important role in nasal physiology.
A: You should code this service with CPT code 30140 – Submucous resection inferior turbinate, partial or complete, any method with modifier 50- Bilateral procedures.
A submucosal resection of the turbinate is removal of bone from the lower turbinates. The turbinates are 3 sets of structures that line the inside wall of the nasal cavity. They are made of small bones that are surrounded by soft tissue. These turbinates filter, moisten, and heat air as it enters the nose.
In 30130, the physician cuts out the inferior turbinate and surrounding submucosal tissue. With 30140, you will want to see that the submucosa is entered and the bone is resected and removed.
Coblation involves using a long thin probe to deliver radiofrequency (heat) energy to the swollen turbinates. Once the turbinates are treated, scar tissue forms and causes the turbinates to shrink. Your doctor will use local anesthesia (numbing of the area) to perform the procedure, which takes only 10 to 20 minutes.
What Is Submucous Resection Of The Inferior Turbinates? This is a type of medical surgery that aims to reduce the size of the nose's inferior turbinates. A submucous resection is common for patients who have enlarged turbinates that cause complicating symptoms with breathing.
Turbinate surgery, or inferior turbinate reduction, is a procedure where the inferior nasal turbinates are examined and reduced in size to provide improved nasal airflow. Surgery is typically performed through the nostrils on both sides of the nose.
CPT code 30140 is considered to be unilateral and would be billed with bilateral modifier-50.
If a surgical procedure was performed simply to gain access to another anatomic area, payors will generally not reimburse. The following CPT codes are considered unilateral: 30130 and 30140.
CPT® 61782, Under Stereotaxis Procedures on the Skull, Meninges, and Brain. The Current Procedural Terminology (CPT®) code 61782 as maintained by American Medical Association, is a medical procedural code under the range - Stereotaxis Procedures on the Skull, Meninges, and Brain.
Coblation (cold ablation, cool ablation, ionised field ablation, plasma‐mediated ablation, radiofrequency ablation or low‐temperature plasma excision) is a tonsillectomy technique first developed for use in orthopaedic surgery. Coblation is an example of high‐frequency electrosurgery.
Repairing or straightening a deviated septum and reducing enlarged turbinates is a common nasal surgery done under general anesthesia. A small incision is made inside the nose and the thin plate of cartilage and bone in the center of the nose is repaired.
Radiofrequency turbinate reduction is a procedure in which a needle-like instrument is inserted into the turbinate and energy is transmitted to the tissue to cause a controlled damage, so by the time healing process occurs, the turbinates will be reduced, allowing improved airflow through the nose.
How long does it take to recover from turbinate reduction? You'll be able to return to work, school and other normal routines in one day if you have the in-office procedure, and in one week if you have the procedure under general anesthesia. Complete turbinate reduction recovery can take up to six weeks.
The surgery may be done through a lighted camera (endoscope) that is placed into the nose. You may have general anesthesia or local anesthesia with sedation, so you are asleep and pain-free during surgery.
In one study 82% of people were satisfied with the results of turbinate surgery one month after their procedure but this declined steadily with time to 60% at 3 months and 54% at 1 year. The surgical method used didn't greatly affect the success rate. As with any medical procedure there are some potential risks.
While turbinate surgery is generally safe, there are a few risks. The main risk is removing too much tissue, which means the turbinates can't warm and humidify the air you breathe. The result is a permanently dry, crusty nose that can be painful. This risk is less likely with the powered turbinoplasty method.
Turbinates are bony plates covered by spongy mucosa also known as Conchae.
The middle turbinate is a part of the ethmoidal labyrinth (bone), projecting from the lateral wall of the nasal cavity
Prior to January 2006, CPT did not specifically differentiate the turbinates. At present, CPT codes 30130 and 30140 now refer specifically to the inferior turbinates (as do codes 30801, 30802, and 30930). Clinically, as the AAO-HNS continues to stress, the inferior turbinates are not associated with sinus surgery or are they inherently part of, or necessary to address when performing, septal surgery. Turbinate surgery, while carried out transnasally, involves separate anatomical sites, application of separate clinical judgment, surgical technique and instrumentation and thus should be reported and reimbursed separately from sinus and septal operations. However, in a strict anatomic sense, the middle turbinate is part of the ethmoid bone. Therefore, if the middle turbinate is removed when performing endoscopic ethmoidectomy (codes 31254, 31255) or endoscopic polypectomy (code 31237), the removal of the middle turbinate (code 30999) would not be reported separately. You may report the inferior or superior turbinate procedures separately when the documentation accurately reflects the correct anatomical site. It has long been the position of the Academy that middle turbinectomy procedures CPT code 30999 are separate from procedures on the sphenoid, maxillary, or frontal sinus or the nasal septum. Resection of a concha bullosa 31240 is reported separately from all sinus and septal surgery.
Turbinates that are obstructive and not responding to aggressive medical management may require surgical treatment.
This involves carefully elevating the mucosal lining that overlies the bone of the turbinate and removing the enlarged portions of bone. The lining is then replaced and the remaining bone is pushed outwardly to enlarge the nasal airway. It is important to remember that the inferior turbinates play an important role in nasal physiology.
A proper turbinate reduction procedure must reduce the size of the turbinate enough to achieve a wider nasal airway while leaving the majority of its lining intact. This will ensure that the patient gets the most of out of the procedure without worsening symptoms.
They serve to warm and humidify the air that we breathe and to regulate the amount of air that we can breathe in at once. Removing too much of the inferior turbinates can result in the sensation of worsening congestion called “empty nose” syndrome or excessively dry nasal condition called rhinitis sicca. A proper turbinate reduction procedure must reduce the size of the turbinate enough to achieve a wider nasal airway while leaving the majority of its lining intact. This will ensure that the patient gets the most of out of the procedure without worsening symptoms.
Yes, they are present in everyone’s nose unless removed by a physician. Some people even have extra or accessory turbinates.
Yes, there are many procedures available such as turbinate out-fracture, coblation, and cautery. Most of these procedures attempt to create a scarring reaction within the turbinate to reduce their size. While numerous effective techniques exist, there is a lack of consensus regarding the best one and the long-term results of these procedures are mixed. Under certain circumstances, our physicians may employ some of these other techniques to give our patients the best individualized care possible.