How To Use CPT Code 30468

CPT 30468 describes the repair of nasal valve collapse using subcutaneous or submucosal lateral wall implants. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 30468?

CPT 30468 is used to report the repair of nasal valve collapse by utilizing one or more implants that are placed beneath the skin or mucous membrane in the lateral wall of the nose. This procedure is performed to address impaired nasal breathing caused by various factors such as scar tissue, age-related changes, or other causes.

2. Official Description

The official description of CPT code 30468 is the repair of nasal valve collapse with subcutaneous/submucosal lateral wall implant(s). It is important to note that this code should not be reported in conjunction with codes 30465 or 30469 when performed on the same side. For the repair of nasal vestibular stenosis, code 30465 should be used. If the repair does not involve cartilage graft, lateral wall reconstruction, or subcutaneous/submucosal implant, code 30999 should be used.

3. Procedure

1. The provider begins by preparing and anesthetizing the patient appropriately.
2. An implant is introduced at the nasal valve area, which is also known as the flow limiting segment.
3. The implant is placed either subcutaneously beneath the skin or submucosally beneath the mucous membrane in the lateral wall of the nose.
4. The procedure may involve the use of one or more implants to address the nasal valve collapse.
5. This repair aims to improve nasal breathing and alleviate symptoms caused by the collapse.

4. Qualifying circumstances

CPT 30468 is performed on patients with nasal valve collapse, a condition that narrows the nasal valve area and impairs nasal breathing. The procedure is suitable for patients who experience difficulties in breathing due to scar tissue, age-related changes, or other causes affecting the nasal valve. It is important to note that this code should not be reported with codes 30465 or 30469 when performed on the same side. For nasal vestibular stenosis repair, code 30465 should be used. If the repair does not involve cartilage graft, lateral wall reconstruction, or subcutaneous/submucosal implant, code 30999 should be used.

5. When to use CPT code 30468

CPT code 30468 should be used when the provider performs a repair of nasal valve collapse using subcutaneous or submucosal lateral wall implants. It is important to ensure that the procedure does not involve cartilage graft, lateral wall reconstruction, or other techniques that would require different codes. This code is specific to the repair of nasal valve collapse and should not be used for other nasal procedures.

6. Documentation requirements

To support a claim for CPT 30468, the provider must document the following information:

• Patient’s diagnosis of nasal valve collapse
• Description of the procedure performed, including the use of subcutaneous or submucosal lateral wall implants
• Date of the procedure
• Any additional details or complications encountered during the procedure
• Signature of the performing provider

7. Billing guidelines

When billing for CPT 30468, it is important to ensure that the procedure involves the repair of nasal valve collapse using subcutaneous or submucosal lateral wall implants. This code should not be reported with codes 30465 or 30469 when performed on the same side. Additionally, if the repair does not involve cartilage graft, lateral wall reconstruction, or subcutaneous/submucosal implant, code 30999 should be used. It is crucial to follow the specific guidelines and modifiers provided by the payer to ensure accurate billing and reimbursement.

8. Historical information

CPT 30468 was added to the Current Procedural Terminology system on January 1, 2021. There have been no updates or changes to the code since its addition.

9. Examples

1. A patient undergoes a repair of nasal valve collapse using subcutaneous lateral wall implants to address impaired nasal breathing caused by scar tissue.
2. A provider performs a procedure to repair nasal valve collapse by utilizing submucosal lateral wall implants in a patient experiencing age-related changes that affect nasal breathing.
3. Another patient undergoes a repair of nasal valve collapse using both subcutaneous and submucosal lateral wall implants to alleviate symptoms caused by the collapse.
4. Provide seven more examples of cases in which CPT code 30468 should be billed. Only explain the examples and make them all original.