30110

👃 CPT 30110 — Excision, Nasal Polyp(s), Simple

Quick Reference

wRVU: 4.05 | Global Period: 010 (10 days) | Assistant Payable: ❌ No | Bilateral Indicator: 1

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📋 Clinical Description

CPT 30110 describes the simple, non-endoscopic excision of one or more nasal polyps from the nasal cavity using intranasal instruments — typically biting forceps, cup forceps, or an ear snare — with or without local/topical anesthesia. This code applies regardless of the number of polyps removed as long as the procedure remains limited in scope and is performed without an endoscope. It is distinguished from 30115 (Excision, nasal polyp(s), extensive) by the limited nature of the dissection and typically the more accessible anterior location of the polyps; it is distinguished from 31237 (Nasal/sinus endoscopy, surgical; with biopsy, polypectomy or debridement) by the critical absence of endoscopic visualization — if any endoscope is used, 31237 replaces 30110 regardless of the scope of polyp removal. In contemporary ENT practice, 30110 has become comparatively rare as the vast majority of nasal polypectomies are performed endoscopically; however, it remains valid for accessible office-based non-endoscopic removal.

Nasal polyps are benign, inflammatory, edematous outgrowths of the nasal or sinus mucosa arising most commonly from the lateral nasal wall, middle meatus, or ethmoidal region. They are strongly associated with chronic eosinophilic inflammation, allergic rhinitis, aspirin-exacerbated respiratory disease (Samter triad), and cystic fibrosis. Untreated polyps cause progressive nasal obstruction, anosmia, and recurrent sinusitis; large or bilateral polyp burdens may extend into the nasopharynx. When polyps are confirmed or suspected to be neoplastic rather than inflammatory, biopsy and pathologic evaluation are mandatory — malignant nasal neoplasms code to C30.0 rather than J33.- and require a different surgical approach entirely.

This procedure may be performed in the following clinical contexts:

• Single accessible nasal polyp, office-based removal — A discrete, anteriorly located polyp reachable with intranasal forceps without endoscopic guidance; the prototypical 30110 scenario in contemporary practice.
• Recurrent nasal polyp, limited regrowth — Polyp recurrence following prior treatment (medical or surgical) where regrowth is accessible and limited in scope; document recurrence explicitly for medical necessity; modifier -58 applies if within the global window of a prior polypectomy.
• Nasal polyp in a patient with allergic rhinitis or chronic sinusitis — Secondary diagnosis codes J30.- or J32.- are reported alongside J33.0 to capture the underlying inflammatory disease driving polyp formation and support medical necessity.
• Nasal polyp in a patient with aspirin-exacerbated respiratory disease (Samter triad) — Polyps in this population are frequently recurrent and aggressive; document the underlying diagnosis (asthma + aspirin sensitivity + nasal polyps) fully to support medical necessity for repeated interventions.
• Pediatric nasal polyp with cystic fibrosis — CF-associated nasal polyposis is particularly recurrent; ICD-10-CM code E84.19 (cystic fibrosis with other intestinal manifestations) or E84.0 (CF with pulmonary manifestations) is reported as a secondary code; the polyp code remains J33.0.

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🔬 Anatomical & Procedural Considerations

Technique Variant	Mechanism / Steps	Coding & Clinical Notes
Forceps / Biting Forceps Avulsion	Topical vasoconstrictor (e.g., oxymetazoline or cocaine) applied intranasally; local anesthetic injected around polyp base; biting forceps or cup forceps used to grasp and avulse the polyp from its stalk	Most common technique for 30110; the operative note must confirm no endoscope was used; if any endoscope is introduced, the service shifts to 31237
Ear Snare (Wire Loop)	Wire snare loop placed around the polyp stalk and tightened to transect the polyp at its base; bleeding controlled with packing or epinephrine-soaked pledgets	Acceptable technique for 30110; document the instrument used, the polyp site, and unilateral vs. bilateral; snare technique does not change the code selection
Surgical Curettement	Curettage of accessible polyp tissue using a nasal curette; less common for defined polyps, more common for polypoid degeneration of mucosa	Appropriate under 30110 for simple accessible lesions; if extensive curettage is performed with endoscopic visualization, 31237 applies
Bilateral Non-Endoscopic Removal	Same technique performed in both nasal passages in the same session	Report 30110-50 for bilateral procedures; note that AAPC and ENT coding guidance confirm -50 is appropriate for bilateral nasal polyp excision when performed non-endoscopically

Clinical Pearl

The single most important code-selection rule for this family is: endoscope used = 31237; no endoscope = 30110 or 30115. In 2026 ENT practice, it is genuinely rare for a surgeon to remove nasal polyps without endoscopic visualization — the standard of care has shifted almost entirely to endoscopy. When you see 30110 on a claim, the operative note must affirmatively confirm the absence of an endoscope. If the note mentions any nasal endoscope, sinus scope, or rigid/flexible nasal telescope and a polypectomy was performed, 31237 is the correct code — not 30110. Auditors reviewing ENT claims for this code will look specifically for endoscope documentation as the first audit step.

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✅ Procedure Includes

• Pre-procedure nasal examination and identification of polyp location(s) to be excised
• Application of topical vasoconstrictor and/or topical anesthetic to the nasal mucosa
• Local anesthetic infiltration at the polyp base when performed
• Intranasal excision of the polyp(s) using forceps, snare, or curette — without endoscopic guidance
• Hemostasis via nasal packing, electrocautery, or epinephrine-soaked pledgets as needed
• Routine post-procedure nasal care and patient instructions
• Documentation of technique, laterality, number of polyps, and confirmation that no endoscope was used

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❌ Excludes / Do Not Report Together

Code	Description	Relationship to 30110
30115	Excision, nasal polyp(s), extensive	Sibling code in the non-endoscopic family — mutually exclusive with 30110 in the same session for the same nasal passage; select 30115 when the procedure is more extensive in scope (larger polyp burden, deeper dissection, greater tissue removal) without an endoscope; not distinguished by polyp count alone but by procedural complexity and documentation
31237	Nasal/sinus endoscopy, surgical; with biopsy, polypectomy or debridement (separate procedure)	Replaces 30110 entirely when any endoscope is used during the polypectomy; do NOT report 30110 and 31237 for the same nasal passage in the same session — if an endoscope is introduced and a polypectomy is performed, 31237 is the correct and only code for that nasal passage
31231	Nasal endoscopy, diagnostic, unilateral or bilateral	Diagnostic-only nasal endoscopy; when a diagnostic endoscopy is followed immediately by a non-endoscopic polyp excision in the same session, 31231 is generally bundled; confirm NCCI edit status before reporting separately
30100	Biopsy, intranasal	Separately reportable only when a distinct biopsy of a separate lesion (not the polyp itself sent for pathology as part of the excision) is performed; a biopsy of the polyp tissue sent routinely to pathology does not warrant separate 30100 billing
E/M codes (992xx / 920xx)	Office visit, any level	Separately reportable only when modifier -25 is appended to the E/M code, documenting a significant, separately identifiable evaluation and management service beyond the pre-procedure assessment for the nasal polypectomy

Bundling Alert — Global Period is 010, Not 090 or 000

CPT 30110 carries a 10-day global surgical package, meaning all routine post-operative nasal care visits, packing removal, and wound checks within Days 1-10 are bundled into the single 30110 payment. This is shorter than the 90-day global for major ENT procedures (e.g., 30520, septoplasty, 090) but still requires active tracking. The most common billing error in this setting is scheduling a packing removal visit on Day 2-3 and billing it as a separate E/M without the appropriate global modifier. For any E/M visit within the 10-day window for a condition unrelated to the polypectomy, append modifier -24 to the E/M code with explicit documentation of the unrelated nature. Compare to 30115 (also 010 global) and 31237 (000 global) — the different global periods across sibling codes are a frequent source of billing errors.

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🌳 Code Tree — Surgery: Nose, Excision Procedures

CPT 30100-30160  Excision Procedures on the Nose
│
├── 30100  Biopsy, intranasal  (Global: 000)
│
├── 30110-30115  Excision, nasal polyp(s) — Non-Endoscopic
│   ├── ▶▶ 30110 ◀◀  Simple  ← YOU ARE HERE  (Global: 010)
│   └── 30115  Extensive  (Global: 090)
│
├── 30117-30118  Excision or Destruction, Intranasal Lesion
│   ├── 30117  Internal approach  (Global: 010)
│   └── 30118  External approach — lateral rhinotomy  (Global: 090)
│
├── 30120  Excision or surgical planing of skin of nose for rhinophyma  (Global: 090)
│
├── 30124-30125  Excision of Dermoid Cyst, Nose
│   ├── 30124  Simple — not involving skin  (Global: 090)
│   └── 30125  Complex — involving skin  (Global: 090)
│
└── 30130-30160  Excision of Turbinate(s) / Nasal Tissue
    ├── 30130  Excision inferior turbinate, partial or complete  (Global: 090)
    ├── 30140  Submucous resection inferior turbinate  (Global: 090)
    └── 30160  Total rhinectomy  (Global: 090)

CPT 31231-31297  Nasal/Sinus Endoscopy — Key Related Family
├── 31231  Diagnostic nasal endoscopy  (Global: 000)
├── 31237  Surgical; with biopsy, polypectomy or debridement  (Global: 010)
└── 31254-31255  Surgical; with ethmoidectomy  (Global: 090)

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💰 RVU & Reimbursement Profile

Component	Value
Work RVU (wRVU)	4.05 (verify against current CMS MPFS for applicable year)
Global Period	010 (10 days)
Bilateral Indicator	1 — Subject to standard 150% bilateral payment adjustment rules
Assistant Surgeon	❌ Not payable
Co-Surgeon	❌ Not applicable
Team Surgery	❌ Not applicable
PC/TC Split	❌ No — procedure code only (Indicator 0)
Modifier -51 Exempt	No
Anesthesia	Topical and/or local infiltration anesthesia included; no separate anesthesia billing expected for standard office or ASC procedure; general anesthesia separately billable by the anesthesiologist when the procedure is performed under GA in an OR or ASC setting

Bilateral Billing Rules

30110 has a bilateral indicator of 1, meaning it is subject to the standard Medicare 150% bilateral payment adjustment. Nasal polyps are frequently bilateral, and bilateral non-endoscopic polypectomy in the same session is reported with modifier -50 on a single line (1 unit) per CMS/NCCI policy, or on two lines with -RT and -LT per some commercial payer preferences — verify your MAC’s billing format. Medicare pays the lower of: (a) total actual charges for both sides, or (b) 150% of the fee schedule amount for a single 30110 (100% for the first side, 50% for the second side). AAPC ENT coding guidance explicitly confirms that modifier -50 is the appropriate modifier for bilateral non-endoscopic nasal polyp excision.

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🏷️ Modifier Reference

Modifier	Name	When to Apply
-50	Bilateral Procedure	Nasal polyp excision performed in both nasal passages in the same session; most common modifier scenario for this code given the bilateral nature of nasal polyposis; verify MAC preference for single line with -50 vs. two lines with RT/LT
-RT	Right Side	When unilateral polypectomy is confirmed to be right-sided only; document laterality in the operative note
-LT	Left Side	When unilateral polypectomy is confirmed to be left-sided only
-25	Significant, Separately Identifiable E/M	Applied to the E/M code — not 30110 — when a separately documented office visit with distinct medical decision-making is performed on the same date; must address a condition beyond the pre-procedure assessment for the polyp
-24	Unrelated E/M During Postoperative Period	Applied to the E/M code when the patient returns within the 10-day global window for a condition unrelated to the polypectomy; document the unrelated nature explicitly
-51	Multiple Procedures	When 30110 is performed alongside other surgical procedures (e.g., septoplasty, turbinate reduction) in the same session; apply to the lower-valued code
-59	Distinct Procedural Service	When payers inappropriately bundle 30110 with another distinct procedure in the same session; documents a separate anatomic site or distinct service — e.g., when 30110 is performed alongside 30520 (septoplasty) and an NCCI edit is triggered
-52	Reduced Services	Procedure partially completed — document reason; e.g., patient unable to tolerate the procedure beyond partial polyp removal
-53	Discontinued Procedure	Procedure stopped due to patient safety concern; document reason thoroughly
-58	Staged or Related Procedure	Planned repeat polypectomy within the 10-day global period of a prior 30110 or 30115; e.g., staged bilateral removal when only one side was treated at the initial session
-78	Unplanned Return to OR	Unplanned return to the OR within the 10-day global period for a complication (e.g., significant epistaxis requiring operative intervention)
-79	Unrelated Procedure During Postoperative Period	Unrelated surgical procedure performed during the 10-day global window; appended to the unrelated procedure code

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🩺 Common ICD-10-CM Pairings

Primary — Nasal Polyp (J33 Category)

ICD-10 Code	Description	HCC?	Clinical Notes
J33.0	Polyp of nasal cavity	❌ No	Most specific and most commonly reported primary diagnosis for 30110; use when the provider documents a nasal cavity polyp — arising from the lateral nasal wall, inferior or middle turbinate, or nasal septum — without extension into the sinuses; “nasal polyp” in the clinical note maps here
J33.1	Polypoid sinus degeneration	❌ No	Woakes syndrome — diffuse polypoid degeneration of the sinus mucosa with extensive nasal polyp formation; use when the provider specifically documents this pattern vs. a discrete polyp; often associated with larger polyp burden that may drive 30115 rather than [[30110]]
J33.8	Other polyp of sinus	❌ No	Use when the provider documents a polyp arising from the sinus mucosa (maxillary, ethmoidal, sphenoidal, or frontal sinus origin) rather than the nasal cavity proper; distinct from J33.0 — site of origin matters
J33.9	Nasal polyp, unspecified	❌ No	Least specific — use only when the provider’s documentation does not distinguish between nasal cavity polyp and sinus polyp; query provider before defaulting to unspecified when site of origin can be clarified

Associated Inflammatory / Comorbid Conditions

ICD-10 Code	Description	HCC?	Clinical Notes
J32.0	Chronic maxillary sinusitis	❌ No	Report as secondary diagnosis when the provider documents concurrent chronic maxillary sinusitis — highly common comorbidity with nasal polyposis; supports medical necessity for surgical intervention and postoperative antibiotic coverage
J32.4	Chronic pansinusitis	❌ No	When the provider documents involvement of all sinuses (pan-sinusitis) concurrent with nasal polyps; more extensive inflammatory burden; may support escalation to 30115 or endoscopic approach if documented
J32.9	Chronic sinusitis, unspecified	❌ No	Use when concurrent sinusitis is documented but specific sinus involved is not identified; query provider for specificity when possible
J30.9	Allergic rhinitis, unspecified	❌ No	Report as secondary when allergic rhinitis is an identified contributing factor to polyp formation; supports medical necessity and documents the inflammatory etiology; query for specific allergen if documented (J30.1 for pollen, J30.2 for other seasonal, J30.89 for other)
J45.909	Unspecified asthma, uncomplicated	❌ No	Nasal polyposis is strongly associated with asthma (especially in aspirin-exacerbated respiratory disease / Samter triad); report asthma as secondary diagnosis when documented; query for intermittent vs. persistent and severity for specificity

Underlying Etiology / Special Population Codes

ICD-10 Code	Description	HCC?	Clinical Notes
T39.012A	Poisoning by aspirin, accidental, initial encounter	❌ No	Used in acute aspirin toxicity context — NOT the standard code for Samter triad; for aspirin-exacerbated respiratory disease, code the underlying conditions (asthma + J33.0 + **Z88.**0 adverse effect to aspirin)
Z88.0	Allergy status to penicillin	❌ No	Shown for awareness — document aspirin sensitivity separately using Z88.9 (allergy to unspecified drugs) or the appropriate Z88.- code when aspirin sensitivity is the documented trigger for the nasal polyp inflammatory cascade
E84.0	Cystic fibrosis with pulmonary manifestations	✅ HCC	Report as secondary when cystic fibrosis is the documented underlying condition driving nasal polyposis; HCC-relevant; document the specific CF manifestation type for accuracy

Coding Specificity Reminder

The J33 category does not require laterality at the ICD-10-CM code level — there is no right/left axis in J33.0-J33.9. Anatomic laterality for nasal polyps is captured on the CPT side via -RT, -LT, or -50 modifiers. The most common specificity gap for this code family is the failure to distinguish J33.0 (nasal cavity polyp) from J33.8 (sinus polyp) — the site of origin should be documented by the provider and queried when absent, as it affects the diagnosis code selection. Do not default to J33.9 (unspecified) when the operative or clinic note identifies a specific nasal vs. sinus origin.

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🏥 MS-DRG Considerations (Inpatient)

Inpatient Coding Reminder

CPT 30110 is performed primarily in the outpatient, office, or ASC setting. There are no routine MS-DRG assignments for simple nasal polypectomy — inpatient admission for 30110 alone would not be supported by any payer, MAC, or utilization review body. If a patient undergoing inpatient admission for an unrelated diagnosis (e.g., uncontrolled asthma exacerbation, CF pulmonary crisis) also undergoes nasal polypectomy, an ICD-10-PCS code is assigned for facility completeness but will have minimal DRG impact. When the nasal condition is the driver of an inpatient admission (rare, typically in the setting of complicated sinonasal disease or complications), refer to MDC 03 (Diseases and Disorders of the Ear, Nose, Mouth, and Throat) — DRGs 152-153 (Major Head and Neck Procedures with/without CC/MCC) or DRGs 154-156 (Other Ear, Nose, Mouth and Throat OR Procedures) depending on the full procedure profile.

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🔧 ICD-10-PCS Equivalents (Inpatient Facility Coding)

Note

Inpatient PCS coding for nasal polypectomy is uncommon and rarely affects DRG assignment unless part of a more complex sinonasal surgical admission. The PCS root operation for nasal polypectomy is Excision (B) — cutting out or off, without replacement, a portion of a body part — consistent with polyp removal leaving the surrounding nasal mucosa intact. The body part value is K (Nasal Mucosa and Soft Tissue) regardless of whether one or multiple polyps are removed. The approach value distinguishes non-endoscopic (Via Natural or Artificial Opening, character 7) from endoscopic (Via Natural or Artificial Opening Endoscopic, character 8) technique — this distinction maps directly to the CPT code selection between 30110 and 31237.

PCS Code	Full Description	Applicable Approach
09BK7ZZ	Excision of Nasal Mucosa and Soft Tissue, Via Natural or Artificial Opening, No Device, No Qualifier	Non-endoscopic intranasal excision — maps to CPT 30110 / 30115
09BK8ZZ	Excision of Nasal Mucosa and Soft Tissue, Via Natural or Artificial Opening Endoscopic, No Device, No Qualifier	Endoscopic polypectomy — maps to CPT 31237
09BK0ZZ	Excision of Nasal Mucosa and Soft Tissue, Open Approach, No Device, No Qualifier	Open approach — used only for external rhinotomy or open nasal surgery contexts

PCS Character Analysis — 09BK7ZZ

Position	Character	Value	Definition
1	Section	0	Medical and Surgical
2	Body System	9	Ear, Nose, Sinus
3	Root Operation	B	Excision (cutting out or off, without replacement, a portion of a body part)
4	Body Part	K	Nasal Mucosa and Soft Tissue
5	Approach	7	Via Natural or Artificial Opening (instrument introduced directly into the nasal cavity without endoscopic visualization)
6	Device	Z	No Device
7	Qualifier	Z	No Qualifier

PCS Root Operation: Excision (B) vs. Destruction (5)

• Use Excision (B) when the nasal polyp is physically cut out or avulsed and removed from the nasal cavity — this is the correct root operation for all polypectomy techniques coded under 30110, 30115, and 31237.
• Use Destruction (5) only when the polyp tissue is ablated/destroyed in situ (e.g., laser vaporization or electrocautery applied directly to the polyp without tissue removal) — documentation must confirm in-situ destruction rather than excision.
• The approach character (7 vs. 8) is the PCS axis that maps to the CPT code family distinction: character 7 (Via Natural Opening) = non-endoscopic = 30110/30115; character 8 (Via Natural Opening Endoscopic) = endoscopic = 31237.

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📝 Coding Examples

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Example 1 — Office: Unilateral Simple Nasal Polypectomy, Right Side, with Separate E/M

Clinical Scenario: A 54-year-old established male presents to his ENT physician with worsening right nasal obstruction and decreased sense of smell. Nasal examination reveals a single pedunculated polyp in the right nasal cavity, accessible with intranasal forceps. After topical oxymetazoline spray and local lidocaine injection at the polyp base, the physician removes the polyp using cup forceps without endoscopic assistance. The operative note reads: “Excision of right nasal polyp via intranasal cup forceps approach; no endoscope used; polyp avulsed at base; hemostasis achieved with epinephrine-soaked pledget; specimen sent to pathology.” The physician also separately evaluates the patient’s new complaint of recurrent headaches, documented with independent history, exam, and assessment/plan.

Field	Code	Rationale
CPT 1	30110-RT	Simple non-endoscopic excision of right nasal polyp; RT for right side; operative note confirms no endoscope used — 31237 does not apply
CPT 2	99213-25	Established patient E/M, low complexity; modifier -25 on the E/M code for the separately documented evaluation of new recurrent headaches; NOT appended to 30110
PDx	J33.0	Polyp of nasal cavity — primary reason for the procedure; right-sided per operative note (laterality captured via modifier RT on CPT, not in ICD-10-CM)
SDx	R51.9	Headache, unspecified — diagnosis supporting the separately billed E/M

Note

Modifier -25 belongs on the E/M code (99213), not on 30110. The E/M documentation must independently support a distinct, medically necessary service — here, the headache evaluation clearly constitutes a separate problem. If the E/M note addressed only pre-procedure assessment for the nasal polyp, the E/M would be bundled and not separately billable.

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Example 2 — Office: Bilateral Simple Nasal Polypectomy with Chronic Sinusitis

Clinical Scenario: A 47-year-old female with a known history of chronic rhinosinusitis and allergic rhinitis presents for elective bilateral nasal polypectomy. The physician documents accessible polyps in both nasal passages. Under topical anesthesia with oxymetazoline and lidocaine, the physician removes polyps from both nasal passages using biting forceps without an endoscope. The operative note documents: “Bilateral intranasal polypectomy via biting forceps; no endoscope; right nasal cavity: one polyp excised; left nasal cavity: one polyp excised; hemostasis with packing bilaterally; specimens labeled separately to pathology.” No separate E/M documented.

Field	Code	Rationale
CPT 1	30110-50	Bilateral non-endoscopic nasal polypectomy; modifier -50 for bilateral procedure in the same session; subject to 150% bilateral payment adjustment
PDx	J33.0	Polyp of nasal cavity — bilateral per operative note; laterality captured via -50 modifier on CPT, not in ICD-10-CM
SDx	J32.9	Chronic sinusitis, unspecified — documented comorbidity supporting medical necessity for surgical intervention
SDx	J30.9	Allergic rhinitis, unspecified — documented underlying inflammatory condition; query provider for specific allergen (pollen, dust mite, etc.) to maximize ICD-10-CM specificity

Warning

Billing 30110 bilaterally without modifier -50 (or the payer-preferred RT + LT on two lines) will result in payment for only a single-sided procedure. Verify your MAC’s preferred billing format for bilateral procedures — some MACs (including Palmetto GBA Jurisdiction J/M) prefer a single line with -50 and 1 unit; others prefer two lines with RT and LT respectively. Failure to apply -50 when both sides are treated is a systematic under-billing error.

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Example 3 — ASC: Bilateral Nasal Polypectomy + Septoplasty, Same Session; Global Period Scenario

Clinical Scenario: A 62-year-old male with nasal polyposis and a deviated nasal septum undergoes same-session bilateral simple nasal polypectomy (non-endoscopic) and septoplasty in an ASC under general anesthesia. The operative note documents both procedures distinctly and confirms no endoscope was used for the polypectomy. On Day 8 post-operatively (within the 10-day global for 30110), the patient calls reporting a nosebleed and is seen for epistaxis management.

Field	Code (Surgery Date)	Rationale
CPT 1	30110-50	Bilateral non-endoscopic nasal polypectomy — primary procedure
CPT 2	30520-51	Septoplasty — separately reportable distinct surgical procedure in the same session; modifier -51 on the lower-valued code; verify NCCI edit status between 30110 and 30520
PDx	J33.0	Nasal polyp — primary reason for the polypectomy
SDx	J34.2	Deviated nasal septum — diagnosis supporting the septoplasty

Field	Code (Day 8 — In Global)	Rationale
No E/M billed separately	—	The epistaxis management visit falls within the 10-day global window of 30110; if epistaxis is a post-operative complication of the polypectomy, it is bundled — do not bill a separate E/M or procedure; if epistaxis requires a return to the OR (e.g., packing under anesthesia), report with modifier -78 (unplanned return to OR for complication during global period)

Note

Global period reminder: CPT 30110 carries a 10-day global period; 30520 carries a 90-day global period. When both procedures are performed in the same session, both global periods are simultaneously active starting from the same surgical date. A post-op visit on Day 8 falls within the 10-day global for 30110 AND within the 90-day global for 30520. Any wound check or complication management within Day 90 is bundled under the 30520 global regardless of whether the 10-day 30110 global has expired. Track the longer global window (90 days for 30520) as the controlling global period for the session.

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⚠️ Common Coding Pitfalls

• Reporting 30110 when an endoscope was used: This is the defining audit risk for this code. The AMA CPT descriptor for 30110 implies a non-endoscopic approach; if any rigid or flexible nasal endoscope was introduced and a polypectomy was performed, 31237 is the correct code. In contemporary ENT practice, endoscopic polypectomy is standard of care — the claim examiner’s first question when reviewing a 30110 claim will be whether an endoscope appears anywhere in the operative note. Confirm the absence of endoscopy in the operative note before billing 30110.

• Reporting 30110 and 30115 for the same nasal passage in the same session: 30110 (simple) and 30115 (extensive) are mutually exclusive for the same nasal passage — report only the code that reflects the actual scope of the procedure. If the documentation supports an extensive approach, 30115 replaces 30110; if documentation is ambiguous between simple and extensive, the operative note language determines code selection. Billing both for the same side triggers an NCCI edit and will result in the lesser code being paid only.

• Failing to apply modifier -50 for bilateral procedures: Nasal polyposis is bilaterally symmetric in the majority of patients. When both sides are treated in the same session, 30110-50 (or -RT + -LT on separate lines per MAC preference) must be reported to capture payment for both sides. Billing a single unmodified 30110 when bilateral treatment is documented leaves payment for the second side on the table — this is the most common systematic under-billing pattern for this code.

• Billing a separate E/M for the pre-procedure assessment without a distinct service: The routine evaluation performed on the same date as the polypectomy to confirm the polyp and obtain consent is bundled into the 30110 payment. An E/M with modifier -25 is only separately payable when the provider performs a clinically independent evaluation for a separate, distinct problem — documented with its own history, exam, and medical decision-making. A note reading “evaluated nasal polyp, proceeding with excision” does not support a -25 E/M.

• Applying modifier -25 to 30110 instead of the E/M code: Modifier -25 belongs exclusively on the E/M service code — never on the surgical code. This is among the most frequently cited billing errors in ENT practice audits. Train billing staff on this distinction specifically; confirm your practice management system does not auto-populate -25 on the procedure code.

• Ignoring dual global period tracking after combined polypectomy + septoplasty: When 30110 (010 global) and 30520 (090 global) are performed together, two different global periods are simultaneously active. Post-op visits and complication management must be tracked against the longer of the two global windows — the 90-day septoplasty global controls. Billing a separate E/M for an unrelated condition on Day 30 (outside the 30110 10-day window but within the 30520 90-day window) still requires modifier -24 on the E/M code with unrelated documentation.

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📎 Sources

¹ AMA CPT 2025 Professional Edition — CPT 30110, Surgery: Nose, Excision Procedures; code descriptor and guidelines for nasal polyp excision family (30110-30115) · ² CMS 2025 Medicare Physician Fee Schedule Final Rule (CMS-1807-F) · ³ CMS RVU25A Relative Value Files — wRVU (4.05), global period (010), and bilateral indicator data for CPT 30110 · ⁴ CMS NCCI Correspondence Language Manual 2025 (CMS.gov) — NCCI bundling rules for nasal polypectomy, including bundle with total rhinectomy and relationship to 31237 · ⁵ NCCI Policy Manual Chapter 6 (Surgery: Nose), CMS 2025 — bundling relationships between 30110, 30115, and endoscopic nasal codes · ⁶ ICD-10-CM Official Guidelines for Coding and Reporting FY2026 — Chapter 10: Diseases of the Respiratory System, J33 coding guidance · ⁷ ICD-10-PCS Official Guidelines for Coding and Reporting FY2026 — Root Operation Excision (B), Body System 9 (Ear, Nose, Sinus), Body Part K (Nasal Mucosa and Soft Tissue) · ⁸ AAPC Otolaryngology Coding Alert — “Peruse This Primer for Nasal Polyp Removal Coding Precision” (2025); non-endoscopic vs. endoscopic distinction for 30110 vs. 31237 · ⁹ AAPC Otolaryngology Coding Alert — “Do Not Report 30115 for In-Office Procedures: Reader Question” (2019); 30110 vs. 30115 vs. 31237 selection guidance · ¹⁰ Medtronic Nasal and Sinus Procedures Commonly Billed Codes Reference Sheet — CPT 30110 wRVU and ASC payment rate data · ¹¹ AAPC ICD-10 Code Reference — J33 Nasal Polyp category; aapc.com/codes/icd-10-codes/J33 · ¹² AAPC CPT Code 30110 Reference — aapc.com/codes/cpt-codes/30110 · ¹³ Palmetto GBA Jurisdiction M — Global Period and Bilateral Procedures Policy (2024) · ¹⁴ AAO-HNS (American Academy of Otolaryngology-Head and Neck Surgery) — CPT for ENT: Sinusectomy and Nasal Endoscopy Codes Reference