Coding Ahead
CasePilot
Medical Coding Assistant
CaseConsultant
Instant Email Coding Consultant
Case2Code
Search and Code Lookup Tool
CareerCenter
Medical Coding Job Board
Log in Register free account

Need help choosing the right code?

Ask CasePilot about procedures, modifiers, bundling, and coding guidance.

Try CasePilot

Official Description

Insertion, nasal septal prosthesis (button)

© Copyright 2026 American Medical Association. All rights reserved.

Common Language Description

The procedure described by CPT® Code 30220 involves the insertion of a nasal septal prosthesis, commonly known as a button prosthesis. This intervention is specifically aimed at addressing nasal septal perforations, which are openings or defects in the nasal septum that can lead to various complications, including nasal obstruction, crusting, and discomfort. The button prosthesis serves as a means to close the perforation, providing either temporary or long-term relief depending on the patient's surgical risk profile. In cases where patients are not ideal candidates for more invasive surgical options, the button prosthesis can be utilized for extended periods. The procedure typically begins with the administration of a topical nasal decongestant to facilitate easier access and a local anesthetic to minimize discomfort during the insertion process. The physician may use either a prefabricated or custom-made button, with the former requiring precise measurement and trimming to ensure a proper fit. The insertion technique involves placing the button in the defect with its flanges positioned against the upper lateral cartilage and septal junction, ensuring stability and effectiveness in closing the perforation. This procedure is crucial for improving the quality of life for patients suffering from nasal septal defects.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

The insertion of a nasal septal prosthesis (button) is indicated for the following conditions:

  • Nasal Septal Perforation - This procedure is performed to close a defect in the nasal septum, which can cause symptoms such as nasal obstruction, crusting, and discomfort.
  • Temporary Closure - The button prosthesis may be used for temporary closure of the nasal septal defect until a more definitive surgical procedure can be performed.
  • Long-term Closure for High-Risk Patients - For patients who are not good surgical candidates due to various health risks, the button prosthesis can provide a long-term solution to manage the perforation.

2. Procedure

The procedure for inserting a nasal septal prosthesis involves several key steps:

  • Administration of Decongestant and Anesthetic - Initially, a topical nasal decongestant is administered to reduce swelling and facilitate access to the nasal septum. Following this, a local anesthetic is applied to the area surrounding the defect to ensure patient comfort during the procedure.
  • Measurement of the Perforation - If a prefabricated button is to be used, the physician measures the size of the nasal septal perforation accurately to ensure that the button will fit appropriately.
  • Trimming the Prefabricated Button - The prefabricated button is then trimmed, leaving it slightly larger than the measured defect to ensure a snug fit when inserted.
  • Application of Lubricant - A lubricant is applied to the button to facilitate its insertion into the defect and to minimize friction during the procedure.
  • Placement of the Button - The button is carefully placed into the defect with its flanges positioned against the upper lateral cartilage and septal junction, ensuring that it is securely positioned to effectively close the perforation.
  • Fabrication of Custom Button (if applicable) - In cases where a custom-made button is required, the physician first obtains an intranasal cast of the defect. The button is then fabricated from silicone material, following which it is inserted into the defect using the same technique as described for the prefabricated button.

3. Post-Procedure

After the insertion of the nasal septal prosthesis, patients may be monitored for any immediate complications or discomfort. It is important to provide instructions regarding care and maintenance of the prosthesis, including any necessary follow-up appointments to assess the effectiveness of the closure and the condition of the nasal septum. Patients should be advised to avoid activities that may dislodge the button and to report any signs of infection or unusual symptoms to their healthcare provider promptly. The expected recovery period may vary depending on individual circumstances, but the goal is to achieve a stable closure of the perforation and improve the patient's overall nasal function.

Short Descr INSERT NASAL SEPTAL BUTTON
Medium Descr INSERTION NASAL SEPTAL PROSTHESIS BUTTON
Long Descr Insertion, nasal septal prosthesis (button)
Status Code Active Code
Global Days 010 - Minor Procedure
PC/TC Indicator (26, TC) 0 - Physician Service Code
Multiple Procedures (51) 2 - Standard payment adjustment rules for multiple procedures apply.
Bilateral Surgery (50) 0 - 150% payment adjustment for bilateral procedures does NOT apply.
Physician Supervisions 09 - Concept does not apply.
Assistant Surgeon (80, 82) 1 - Statutory payment restriction for assistants at surgery applies to this procedure...
Co-Surgeons (62) 0 - Co-surgeons not permitted for this procedure.
Team Surgery (66) 0 - Team surgeons not permitted for this procedure.
Diagnostic Imaging Family 99 - Concept Does Not Apply
APC Status Indicator Hospital Part B services paid through a comprehensive APC
ASC Payment Indicator Surgical procedure on ASC list in CY 2007; payment based on OPPS relative payment weight.
Type of Service (TOS) 2 - Surgery
Berenson-Eggers TOS (BETOS) P6C - Minor procedures - other (Medicare fee schedule)
MUE 1
CCS Clinical Classification 33 - Other OR therapeutic procedures on nose, mouth and pharynx
22 Increased procedural services: when the work required to provide a service is substantially greater than typically required, it may be identified by adding modifier 22 to the usual procedure code. documentation must support the substantial additional work and the reason for the additional work (ie, increased intensity, time, technical difficulty of procedure, severity of patient's condition, physical and mental effort required). note: this modifier should not be appended to an e/m service.
51 Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d).
52 Reduced services: under certain circumstances a service or procedure is partially reduced or eliminated at the discretion of the physician or other qualified health care professional. under these circumstances the service provided can be identified by its usual procedure number and the addition of modifier 52, signifying that the service is reduced. this provides a means of reporting reduced services without disturbing the identification of the basic service. note: for hospital outpatient reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well-being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use).
58 Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78.
59 Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25.
78 Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, see modifier 76.)
79 Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.)
AG Primary physician
CR Catastrophe/disaster related
GA Waiver of liability statement issued as required by payer policy, individual case
GC This service has been performed in part by a resident under the direction of a teaching physician
RT Right side (used to identify procedures performed on the right side of the body)
SG Ambulatory surgical center (asc) facility service
XS Separate structure, a service that is distinct because it was performed on a separate organ/structure
Date
Action
Notes
Pre-1990 Added Code added.
Code
Description
Code
Description
Code
Description
Code
Description
Code
Description
CasePilot

Get instant expert-level medical coding assistance.

Ask about:
CPT Codes Guidelines Modifiers Crosswalks NCCI Edits Compliance Medicare Coverage
Example: "What is CPT code 99213?" or "Guidelines for E/M services"