CPT code for septoplasty, septoplasty cpt code, cpt 30520, cpt code 30520, 30520 cpt code

Septoplasty CPT Code 30520 | Description & Billing Guidelines

The 30520 CPT code can be reported for septoplasty and billed to a physician performing surgery on the septum, the cartilage, and the bone that makes up the wall separating the two sides of the nose.

Reasons For A 30520 CPT Code Procedure

The following are why the physician performs a 30520 CPT code septoplasty procedure.

The physician conducts the CPT code 30520 procedure to treat a nose blockage of a patient, commonly known as deviated nasal septum. 

A deviated septum is the dislocation of the wall among the nostrils and causes nasal blockages. Moreover, turbinates (Enlarged bone structures) may also block the part of the nose.

It may also remove nasal polyps and treat chronic sinusitis and other conditions that block the nasal airways. The surgeon seldom suggests a septoplasty CPT code procedure to treat the recurrent nosebleed.

The Septoplasty CPT Code Procedure Explained

The physician remodels the deviated nasal septum and also adjusts the airway obstruction with the septoplasty procedure (billed with CPT 30520).

In addition, they may use different topical vasoconstrictive agents to decrease the blood vessels’ size and administer local anesthesia to the nasal mucosa. 

The physician then creates a vertical incision in the septal mucosa and lifts the mucoperichondrium with the aid of the septal cartilage.

The physician then excises a deviated portion of the bony and cartilaginous septum by soft tissue grafting. The local graft may not be appropriate to report separately from adjacent nasal bones and cartilage. 

If the cartilaginous septum remains bowed, partial or full-thickness incisions are made in the cartilage to straighten the septum. The physician excises the excess cartilage from the bone-cartilage junction.

They close the Incisions in single layers at the end of the procedure. Transseptal sutures and septal splints place to support the septum during healing.

30520 CPT Code Description

CPT 30520 bills for the service when the physician performs submucous resection or septoplasty, with or without cartilage contouring, scoring, or replacement with graft. 

CPT Code 30520: The 30520 CPT code for septoplasty is officially described in CPT’s manual as: “Septoplasty or submucous resection, with or without cartilage scoring, contouring or replacement with graft.”

How To Bill CPT Code 30520

Documentation must establish the medical necessity and appropriateness of CPT 30520 and reflect the patient’s health status and the severity of illness.

The following are the payable ICD 10 CM code in conjunction with the 30520 CPT code :

  • ICD 10 CM code J34.0: Nose’s abscess, furuncle, and carbuncle.
  • ICD 10 CM code J34.1: Cyst and mucocele of the nose and nasal sinus.
  • ICD 10 CM code J34.2: Deviated nasal septum.
  • ICD 10 CM code J34.3: Hypertrophy of nasal turbinates.
  • ICD 10 CM code J34.81: Nasal mucositis (ulcerative).
  • ICD 10 CM code J34.89: Other specified nose and nasal sinuses disorders.
  • ICD 10 CM code J34.9: Unspecified disorder of nose and nasal sinuses.
  • ICD 10 CM code Q30.3: Congenital perforated nasal septum.
  • ICD 10 CM code Q30.8: Other congenital malformations of the nose.
  • ICD 10 CM code Q30.9: Congenital malformation of the nose, unspecified.

CPT 30520 (Septoplasty CPT code) has a 90-day global period, including a 1-day pre-operative and a 90-day postoperative period.

If Turbinate resection CPT 30140 performs in combination with CPT code 30520, it is appropriate to report separately without any modifier assignment according to NCCI.

If harvesting bone/tissue/fat grafts (CPT 15769, CPT 15773, CPT 15774, CPT 20900 – CPT 20924, and CPT 21210) performs in addition to CPT code 30520, it is appropriate to report the CPT code for septoplasty separately without any modifier assignment according to NCCI.

Suppose Liposuction for autologous fat grafting (CPT 15773 and CPT 15774) performs in addition to CPT code 30520. In that case, it is appropriate to report the septoplasty CPT code procedure separately without any modifier assignment according to NCCI.

If the physician performs Excision or destruction (e.g., laser) of the intranasal lesion, it is inappropriate to report the 30520 CPT code in the same session. The CPT code for the septoplasty procedure performs in different sessions and allows for reporting separately. 

If the physician performs balloon septoplasty with no incisions or removal of septal cartilage, it is appropriate to report with CPT code 30999 instead of CPT 30520. 

If the physician obtains tissues for graft, it is appropriate to report with CPT 15769, CPT 20900 – CPT 20924, and CPT 21210 separately. 

If the physician performs septal repair with a button, it is appropriate to report with CPT code 30220 instead of CPT 30520. 

Does CPT 30520 Need A Modifier?

Modifier 47 is applicable CPT 30520 when the surgeon administers general or regional anesthesia to the patient. Therefore, it is not appropriate to report modifier 47 with anesthesia procedures.  

Modifier 76 is appropriate with CPT 30520 when the same physician performs a similar surgery on the septum or the cartilage procedure on the same service date

Modifier 54 is applicable with CPT 30520 when the physician provides surgical care on the septum or the cartilage only. In contrast, Modifier 55 and modifier 56 attach to CPT 30520 when the physician only performs post-management and pre-operative care.   

Modifier 77 is applicable with CPT 30520 when a different physician performs a similar procedure as surgery on the septum or the cartilage on the same service date. 

Modifier 59 is applicable with CPT 30520 when a septum or the cartilage surery procedure by the physician and bundles with another procedure on the same date.     

 Modifier X {E, P, S, U} is applicable instead of Modifier 59 with CPT 30520 when service bills to Medicare insurance. It divides the modifier into four parts for further specification of the septoplasty CPT code procedure.   

Modifier 53 can be reported with CPT 30520 if an unsuccessful attempt for an inguinal hernia repair makes due to unavoidable circumstances like allergic reactions to the substance.   

Modifier 22 applies to CPT 30520 when the septoplasty procedure takes longer than usual and takes extra resources.   

Modifier 23 applies with CPT 30520 when the physician administers general or local anesthesia during a septoplasty procedure, and routinely, this is not required during a normal CPT code 30520 procedure.   

Modifier 52 applies when the physician does not complete the inguinal hernia repair service and terminates due to unavoidable circumstances.   

If physicians believe Medicare will deny such service, reporting with a GA modifier is appropriate. The beneficiary must sign an Advance Beneficiary Notification (ABN), and CPT 30520 must apply the GA modifier to that service.

Reimbursement & RUVS

A maximum of one unit can be a bill on the same service date of CPT 30520. In contrast, the Three units allow when documentation supports the medical necessity of the service.  

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 62321 are $780.58 and 22.55598 when performed in the non-facility.

Example

The following is an example when CPT 30520 bills:

Septoplasty Procedure Description

 The physician performs Open reduction and nasal fracture with nasal septoplasty (Medical Transcription Sample Report)

Pre-Operative Indication

The patient has a nasal fracture along with obstructed deviated nasal septum.

Postoperative diagnosis: Same as indication

Operation: The Physician performs Open reduction and nasal fracture with nasal septoplasty.

Anesthesia: General.

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. 

Septoplasty Procedure Description

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 physician displaces the cartilaginous septum 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 elevates from the left side of the cartilaginous septum, and mucoperiosteum promotes 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 several splints placed with the aid of 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 loss of blood is estimated to be around 7 to 10 ml. 

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