30140 (Submucous Resection) vs 30130 (Excision)

Question:

My work RVUs are down this year.  I do a lot of inferior turbinate submucous resection surgery and I code 30140 (Submucous resection inferior turbinate, partial or complete, any method).  I noticed that the wRVUs for 30140 are now 3.00 and last year they were 3.57.  This is a big hit for me.  I want to use 30130 instead because it has higher wRVUs.  What do I need to document?

Answer:

If the procedure you perform is 30140 then that is the code you should use.  The code with higher RVUs that you want to bill, 30130, is not the same as a submucous resection.  It describes a through-and-through “excision” (first word of the code descriptor) of all or part of the turbinate.  Based on the information you’ve provided, it seems you are accurately coding the procedure.  The issue you’ve identified is that the RVUs for 30140 went down in 2018 to account for the fact that 30140 is now a 0-day global period procedure; it was a 90-day postoperative global period procedure prior to 2018 thus the higher wRVUs.

*This response is based on the best information available as of 5/23/19.