Given the variety of anatomic sites, surgical techniques, and types of instrumentation involved in transnasal turbinate surgery, it is the one of the most difficult coding scenarios.

Your otolaryngologist removes the middle turbinate during an endoscopic ethmoidectomy (31254, Nasal/sinus endoscopy, surgical; with ethmoidectomy, partial [anterior], or 31255, Nasal/sinus endoscopy, surgical; with ethmoidectomy, total [anterior and posterior]) or endoscopic polypectomy (31237, Nasal/sinus endoscopy, surgical; with biopsy, polypectomy or debridement [separate procedure]). The middle turbinates are considered access to the sinuses, so you should be able to tell that the removal of the middle turbinate should not be reported separately.

Check out these 3 frequently asked questions (FAQs) to help master your turbinate surgery coding skills.

Should 30130 and 30140 Go Hand-in-Hand?

Suppose the documentation states that the physician entered or excised mucosa and subsequently preserved it. This implies that you should use 30140 (Submucous resection inferior turbinate, partial or complete, any method) to report this service. However, simply reporting that the turbinate was excised is probably not enough documentation for this code. Don’t forget to bill 30130 (Excision inferior turbinate, partial or complete, any method) if there is no evidence of the preservation of the mucosa and the op note just indicates that the inferior turbinate was excised or resected.

Remember that you should not bill 30140 with 30130 — you would bill one or the other, for a single side. “However, if a submucousal resection (preservation of the mucosa) is performed on one side and a straight excision is performed on the other side (no preservation of mucosa), you would code 30140-RT and 30130-59-LT, for example,” explains Barbara J. Cobuzzi, MBA, CPC, CENTC, CPC-H, CPC-P, CPC-I, CHCC, president of CRN Healthcare Solutions, a consulting firm in Tinton Falls, N.J. The RT and LT would represent which side each procedure...