Tuesday, February 9, 2021

CPT CODE 30801, 30802, 30930, 30130, 30140

Procedure code and Description


 * 30801: cautery and/or ablation, mucosa of inferior turbinates, unilat or bilat, any method; superficial (3.4 rvu)

* 30802: intramural (4.92 rvu) (this includes radiofrequency procedures)

* 30930: fracture inferior turbinates, therapeutic (3.02 rvu)

* 30130: excision inferior turbinate, partial or complete (7.15 rvu)

* 30140: submucous resection of inferior turbinate, partial or complete, any method (7.68 rvu)


INFERIOR TURBINOPLASTY

Coding for turbinoplasty procedures centers on whether bone was removed during procedure. Soft tissue reduction of turbinates, without removal of bone, is reported with code 30802. If bone is removed, it is reported with 30140

HOSPITAL OUTPATIENT CODING AND PAYMENT

Hospitals use CPT codes to report outpatient services. Payment shown is for Medicare’s APC hospital outpatient prospective payment system and is the Medicare national average without geographical adjustment. Status Indicator “T” = significant procedure, multiple reduction applies. Payment for each code is made at 100% of the rate when it is the only significant procedure billed. When billed with another status T procedure with higher weight, payment for lower weighted procedures is reduced to 50% of the rate.


CPT code 30802 is used for both unilateral or bilateral procedures and may be reported only once per operative session. Use of the phrase “any method” in the code definition indicates that the specific instruments and techniques used to accomplish the reduction do not alter the code assignment. Intramural ablation of the turbinates includes any ablation of the superficial tissues so the code for superficial ablation (30801) is not assigned separately with 30802. CPT code 30140 is considered to be unilateral and would be billed with bilateral modifier-50.


INFERIOR TURBINOPLASTY WITH OUTFRACTURE

Turbinoplasty and outfracture are sometimes performed together. According to NCCI edits or CPT descriptions, CPT code 30930 should not be billed with 30140. If CPT codes code 30802 and 30930 are reported together, only one code is paid unless procedures are performed independently on opposite sides.


b. Resection Inferior Turbinate (CPT code 30140)

CMS finalized the RUC recommended value of 3.00 RVUs for this code. One notable comment received related to this code included a request that CMS add a new supply named the “turbinate reduction wand” to the supply inputs associated with this procedure when performed in the physician office setting. The commenter stated that this device is designed to ablate, coagulate, and remove a core of tissue that provides the desired volumetric reduction of the anatomy, and supplied several invoices for use in pricing the new supply.


CMS responded stating the suggested turbinate reduction wand has a price of nearly $200, which would add substantially to the costs of CPT code 30140. Before including such significant resource costs in the code, they requested input from the physician community such as the RUC. At present, they do not have any information to suggest that the use of this new supply is typical for CPT code 30140, and the RUC did not recommend the inclusion of this supply on either of the two occasions when this code was reviewed in CY 2017. For these reasons, CMS did not believe that it would be appropriate to add the turbinate reduction wand to CPT code 30140 at this time, but welcomed the submission of additional information regarding this use of this supply from stakeholders.



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