How To Use CPT Code 30520

CPT 30520 describes a specific procedure performed on the nose, known as septoplasty or submucous resection. This article will provide an overview of CPT code 30520, including its official description, the procedure itself, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 30520?

CPT 30520 is a code used to describe a surgical procedure called septoplasty or submucous resection. This procedure is typically performed to correct a deviated septum, which can be in the shape of a C, S, or involve cartilage deviation. It is important to note that for submucous resection of turbinates, a different code, 30140, should be used.

2. Official Description

The official description of CPT code 30520 is: ‘Septoplasty or submucous resection, with or without cartilage scoring, contouring or replacement with graft.’ It is important to use the appropriate code based on the specific procedure performed and any additional techniques used, such as cartilage scoring, contouring, or grafting.

3. Procedure

1. The procedure begins with the administration of local anesthesia to the patient.
2. The healthcare provider then makes an incision, either a Freer hemitransfixion incision or a Killian incision, depending on the area of the septum that needs to be addressed.
3. Once the incision is made, the cartilaginous and bony septum is exposed, and the mucosal flap is elevated.
4. A Tru-Cut® instrument is used to remove any irregular bones and cartilage, ensuring that the septum is properly aligned.
5. After the necessary corrections are made, the flaps are returned to their normal position.
6. The incision is then closed using sutures, and a splint may be applied to support the healing process.

4. Qualifying circumstances

Septoplasty or submucous resection is typically performed on patients with a deviated septum that causes functional issues, such as difficulty breathing or chronic sinusitis. The procedure is performed by a qualified healthcare provider who has the necessary training and expertise in nasal surgery. It is important to note that the specific circumstances and medical necessity for the procedure should be documented in the patient’s medical record.

5. When to use CPT code 30520

CPT code 30520 should be used when performing septoplasty or submucous resection procedures. It is important to ensure that the procedure aligns with the official description of the code, including any additional techniques used, such as cartilage scoring, contouring, or grafting. If the procedure involves submucous resection of turbinates, a different code, 30140, should be used.

6. Documentation requirements

To support a claim for CPT code 30520, the healthcare provider must document the following information:

• The patient’s diagnosis and the medical necessity for the procedure
• The specific techniques used during the procedure, such as cartilage scoring, contouring, or grafting
• The date of the procedure and the duration of the surgery
• Any complications or unexpected findings during the procedure
• Post-operative care instructions and any follow-up appointments scheduled
• The provider’s signature and credentials

7. Billing guidelines

When billing for CPT code 30520, it is important to ensure that the procedure performed aligns with the official description of the code. Additionally, it is crucial to follow any specific billing guidelines provided by insurance companies or payers. It is also important to note that CPT code 30520 should not be reported with other codes, such as 30140, for submucous resection of turbinates.

8. Historical information

CPT code 30520 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates or changes to the code since its addition.

9. Examples

1. A patient undergoes septoplasty to correct a deviated septum that is causing chronic sinusitis and difficulty breathing.
2. A healthcare provider performs submucous resection with cartilage scoring to address a severely deviated septum in a patient with nasal obstruction.
3. A patient undergoes septoplasty with contouring to correct a C-shaped deviation of the septum that is causing recurrent nosebleeds.
4. A healthcare provider performs septoplasty with grafting to address a cartilaginous deviation in a patient with nasal valve collapse.
5. A patient undergoes submucous resection without cartilage scoring to correct a deviated septum that is causing chronic congestion and sinus pressure.
6. A healthcare provider performs septoplasty with cartilage replacement using a graft to address a severely deviated septum in a patient with chronic sinusitis.
7. A patient undergoes submucous resection with contouring to correct an S-shaped deviation of the septum that is causing recurrent sinus infections.
8. A healthcare provider performs septoplasty without cartilage scoring to address a cartilaginous deviation in a patient with nasal obstruction and snoring.
9. A patient undergoes submucous resection with cartilage scoring to correct a deviated septum that is causing chronic headaches and facial pain.
10. A healthcare provider performs septoplasty with grafting to address a C-shaped deviation of the septum in a patient with nasal valve collapse and difficulty breathing.