# Rhinoplasty vs Functional Rhinoplasty



## hdavis34 (May 8, 2014)

I don't code these a whole lot and am starting to wonder if I am just way off base with this. 

Op:
1. Nasal fracture 2. Nasoseptal Deviation 3. Nasal Vestibular Stenosis

Procedure:
1. Repair of Nasal Fracture
2. Repair of nasal vestibular stenosis

Septum was significantly deviated to the left nasal fracture. The lower lateral cartilages were divided and septum encountered. the left mucoperichondrial flap was elevated with cottle knife. Further back there was some more significantly deviated portions, which were removed with forceps and a chisel was then used to chisel off prominent maxiallary crest blocking nasal cavity. Still nasal vestibular stenosis on left due to lack of support of the columella and nasal tip. A 1.5 cm piece of cartilage was trimmed off of harvesting cartilage from the nasal septum and placed at columella pocket and sewn to the anterior septum. Gave the tip the support needed in repair of the nasal vestibular stenosis. 

We coded 30420 (because 30465 is bundled) and are trying to make sure that we shouldn't just go to 30465 without 30420. Confused really about what makes a rhinoplasty functional and just for cosmetic purposes.   

Any input would be great. Thanks!


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## ABonnell CPC (May 8, 2014)

30420 & 30465 are not bundled, you can bill both together with the appropriate modifier.  If the spreader graft was created out of septum cartilage, you cannot bill seperately for the harvest of the graft.  I've learned this through the ASPS coding workshops.


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## ABonnell CPC (May 8, 2014)

And just and FYI the CCI edit bundling 30520 & 30465 was removed 06/01/2009.


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