Medical Coding 1 CH 6-Notes/Nose

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How are incision codes for a nasal abscess divided?

Whether the abscess is on the nasal mucosa or the septal mucosa.

Coding a nasal abscess depends on the approach used, what are the approaches and how does the coding differ?

External Approach (outside the nose) - coded from the INTEGUMENTARY SYSTEM and Internal Approach (from inside the nose)-coded from the Respiratory System subsection. Medical record will describe the approach.

When coding an incision for a nasal abscess from the Respiratory system subsection, what items are included in the code?

Insertion & removal of tube (drainage) and/or gauze, and any required sutures and/or anesthesia. If supplies are used over and above the normal procedure code, these should be coded with 99070 (medicine code for supplies).

Nose biopsy codes in the Respiratory subsection are used for what type of procedure

Intranasal (inside the nose) if external used code from Integumentary system.

Codes for excision or destruction of lesions inside the nose are divided how?

By approach, internal or external. All methods of lesion destruction (including laser), are included in the Excision codes. Of bilateral use modifier -50

Bones on the inside of the nose

Turbinates

Three sections of the turbinate bones

Inferior, middle, and superior. May be removed for cosmetic reasons. Must document the medical necessity for non-cosmetic procedures to ensure payment.

Introduction codes are used for what purpose?

INJECTION (therapeutic, used to shrink nasal tissue to improve breathing), DISPLACEMENT THERAPY (saline solution flushed into the sinuses to remove mucus or pus), INSERTION (i.e. nasal button to repair a hole in the septum-deviated septum- w/out grafting)

Where would you find plastic surgery procedures in the Respiratory Subsection?

In the Repair category (rhinoplasty, septoplasty, and septal dermoplasty)

Procedure used to reshape the nose internally, externally, or both.

RHINOPLASTY-codes are divided based on the extent (minor, intermediate, major), on whether the septum was also repaired (septoplasty), and on whether the procedure was an initial or secondary (done after an initial) procedure.

Procedure name for rearrangement of the nasal septum

Septoplasty - commonly performed on patient with deviated septum

Nasal Destruction codes are used for what purpose?

Remove excess nasal mucosa or to reduce inflammation. Uses either ABLATION (cutting removal ) or CAUTERIZATION. Codes are divided based on the extent of the procedure (Intramural or Superficial)

Difference between Intramural and Superficial

INTRAMURAL (ablation or cauterization of the deeper mucosa). SUPERFICIAL (ablation or cauterization which involved only the outer layer of mucosa)

Other Procedure codes are used for what purpose?

Nasal hemorrhage (codes are divided according to the type and extent of control required) and therapeutic fractures (fracture and repositioning of nasal turbinate bone, used to alleviate obstructed airflow caused by a previous fracture that has healed out of alignment & resulted in deviation of nose).

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