Septoplasty CPT codes 30520 and CPT 30620 bill for service when the Physician performs on the septum, the cartilage, and the bone that makes up the wall separating the two sides of the nose. The Physician redesigns the nasal septum, correcting airway obstruction. Topical vasoconstrictive agents shrink the blood vessels, and local anesthesia injects into the nasal mucosa.
Description Of The Septoplasty CPT Codes
The following are the reasons why the Physician performs septoplasty:
- Uncontrollable nosebleeds.
- Nasal airway obstruction.
- The patient may have deviated nasal septum due to prior nasal surgeries.
Nasal airway obstruction resulting from a septal deformity causing mouth breathing, recurrent nasal infections are responding slowly to antibiotics, and sleep apnea.
The Physician elevates the mucoperichondrium from the septal cartilage and makes a vertical incision in the septal mucosa. They may excise the deviated portion of the bony and cartilaginous septum with grafts.
Billing Local grafts from adjacent cartilage and the nasal bones is inappropriate. The Physician excises the excess cartilage from the bone-cartilage junction.
The Physician makes partial or full-thickness incisions if the cartilaginous septum remains curved and adjusts the septum.
The Physician closes the incisions via a single layer and incorporates transseptal sutures. The splint may apply to enhance the healing process of the septum.
CPT 30520 bills for service when the Physician performs septoplasty or submucous resection, with or without cartilage scoring, contouring, or replacement with graft.
The official description of CPT code 30520 is: “Septoplasty or submucous resection, with or without cartilage scoring, contouring or replacement with graft.”
CPT 30620 bills for service when the Physician performs Septal or other intranasal dermatoplasties (does not include obtaining graft)
The official description of CPT code 30620 is: “Septal or other intranasal dermatoplasty (does not include obtaining graft).“
A maximum of one unit can be a bill on the same service date of Septoplasty CPT codes 30520 or 30620. In contrast, the Two units allow documentation supporting the service’s medical necessity.
The cost and RUVS of CPT 30520 are $780.58 and 22.55598 when performed in the facility. In contrast, the reimbursement and RUVS of CPT 30520 are $780.58 and 22.55598 when performed in the non-facility.
If Liposuction for autologous fat grafting (15773-15774) ) performs in addition to CPT 30520, it is appropriate to report separately.
If CPT 30117 performs in combination with CPT code 30520 during the same session, It is appropriate to report separately. If the Physician obtains tissues for graft, it is relevant to bill with these 20900–20924 and 21210.
If the Physician performs submucous resection of turbinates, It is appropriate to report with CPT code 30140. For septal repair with a button, report CPT code 30220, balloon septoplasty with no incisions or septal cartilage removal, and CPT code 30999.
Septoplasty CPT code 30520 has a 90-day global period. If any Evaluation and management (E/M) service performs with CPT code 30520, modifier 24 will report with E/M service for an unrelated condition.
Suppose the E/M visit is for post-operative care of a prior surgical procedure if the patient sees an unrelated condition on the exact procedure date. In that case, it is not appropriate to report the E/M code with 30520 separately during the global period. While modifier 25 will be applicable with Septoplasty CPT code 30520.
The following is an example when CPT 30520 bills:
The Physician performs Open reduction and nasal fracture with nasal septoplasty.
(Medical Transcription Sample Report)
The patient has a nasal fracture along with obstructed deviated nasal septum.
Same as indication
OPERATION: The Physician performs Open reduction and nasal fracture with nasal septoplasty.
HISTORY: This eighteen-year-old male fractured his nose while playing football. He has a left nasal obstacle and a reduced nasal bone on the left side.
The Physician administers the general anesthesia to the patient and monitors the EKG, pulse oximetry, and CO2.
The Physician then sterilized the patient with Betadine soap and solution and prepped for the procedure. Nasal mucosa decongests using Afrin pledgets and 1% Xylocaine; 1:100,000.
The Physician injects the epinephrine bilateral nasal septal mucoperichondrium and the nasal dorsum lateral osteotomy sites.
The Physician performs an Inspection, revealing a caudal portion of the cartilaginous septum lying crosswise across the nasal spine and columella obstructing the left nasal valve.
There was a sizeable maxillary crest, and the supramaxillary range had a large spur with the vomer bone touching the inferior turbinate. Further up, the cartilaginous septum is displaced to the maxillary ridge’s left.
A sizeable deep groove was horizontally on the right side, corresponding to the left maxillary crest.
The Physician makes a left hemitransfixion incision. Muco-perichondrium was elevated from the left side of the cartilaginous septum, and mucoperiosteum was promoted from the ethmoid plate.
The Physician creates a tunnel inside the nose and connects the anterior and inferior tunnels to the floor of the left side of the nose. It makes this procedure more complicated in the area of the vomerine spur.
The caudal cartilaginous septum, lying crosswise, was separated from the primary cartilage leaving approximately 1 cm strut—the right side mucoperichondrium releases from the cartilaginous septum, ethmoid plate and maxillary crest area.
The caudal cartilaginous strut sutures to the columella with intermittent #5-0 chromic catgut suture apply to the midline of the nose.
The Physician then the cartilaginous septum anterior to the ethmoid plate deviated to the left side, freeing it from the maxillary crest, nasal dorsum, and ethmoid plate. It sutures in the midline with a transfixion #5-0 plain catgut sutures.
Further posteriorly, the ethmoid plate has deviated to the left side, and the Physician removes the part with Jansen-Middleton punch forceps.
The vomerine crest also caused significant deviation, maxillary ridge, and supramaxillary cartilaginous cartilage.
This area is free from the perichondrium on both sides. The maxillary crest removes with a gouge. The vomer was partially removed with a gauge and paced back to the midline.
Left hemitransfixion incisions were closed with interrupted #5-0 chromic catgut sutures. The septum also filters with #3-0 plain catgut sutures. Thus, the deviated septum corrects by the Physician.
The Physician utilized a transfixion #5-0 nylon suture and placed several splints with a valve. He corrects the deviated nasal septum sutures to the left side of the nose.
Therefore, the nasal bones were refractured back into the midline by compressing the left nasal bone and elevating the right nasal bone with the nasal bone elevator through the nasal cavities. The left intercartilaginous incision makes the nasal bones disimpact sub-periosteally and molds back into the midline.
The Physician applies Steri-Strips to the nasal dorsal skin, and a Denver type of splint uses to support the nasal bones’ dorsal side.
The Physician applies the bandages with bacitracin ointment and packs the nasal cavities, and the blood loss is estimated to be around 7 to 10 ml.