# closed or open reduction nasal fracture?



## chickelala

I think 30520 and 21320.  My co-worker says 30520 and 21330, but can't drop 21330 to the bill because it is an edit.

OP note says," Using a butter knife and manual manipulation, fractured bone of the nose was easily moved.  The outer part of the nose appeared to be straight at this point.        A left hemitransfixion incision made along the right mucoperiosteal tunnel.  His cartilage of the septum was fairly shattered in multiple pieces.  Visibly, these were realigned and it was elected not to remove any of the tissue as they did realign quite well.  These septal mucosal flaps are approximated using 4-0 suture in a running through and through mattress type fashion.  Incision closed using interrupted chromic suture.  Silastic sheeting placed on either side of septum to splint this in and hold in position and secured in the usual fashion.  The right side nose which was concasve was packed with Surgicel to help support nasal bone out into its anatomic position.  External nose then taped.

So, is the second procedure 21320 or 21330?


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## jackjones62

My response is 21336 and 21320, open treatment of nasal septal fx and closed treatment of nasal bone fx; your surgeon did not do a septoplasty, 30520, nor an open treatment of nasal fx, 21330, and there are no CCI edits concerning 21336 and 21330 but I am thinking that you may want to use modifier 59 on 21320, it's your call.

Jennifer
CT ENT


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