# Removal of nasal packing



## smcbroom

PREOPERATIVE DIAGNOSIS:
Nasal fracture.
I need some assistance with this, the physician office when it was scheduled used CPT code 30905 but isn't this code for nasal hemorrhage specifically?  If anyone has another idea, please let me know.  I appreciate your time!  I work at an ASC and this is for a commercial payer.

POSTOPERATIVE DIAGNOSIS:
Nasal fracture.

OPERATION:
Removal of nasal packing posterior required for nasal support.

DESCRIPTION OF PROCEDURE:
Under IV sedation, the Merocel packing was placed.  It was carefully removed.  The nose was suctioned.  The cast had come off over the weekend at home.

The nasal reduction was excellent.  No further treatment was required.  Cole was awakened and returned to recovery in satisfactory condition without complication.


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## 01077395

If this service is the removal of the nasal packing placed during the performance of a treatment of a nasal bone fracture, the removal of the nasal packing is part of the 90-day global services as being part of the initial service.  It follows the same principle as a suture removal, if your doctor placed the sutures they cannot bill for the removal.  If your doctor put in the nasal packing, they cannot bill for the removal.

The 30905 code is specifically for control of nasal hemmorhage (nose bleed) by cautery or placing of packing.  This code is not for placing packing for nasal bone fracture treatment or the removal of that packing.

Hope this helps.


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## smcbroom

just to clarify something because I may be wrong...this wasn't a planned procedure since the cast on his nose came off over the weekend at home so would it still be considered as global billing and part of the primary procedure if it's the same physician?  if not and I can bill for it as an ASC would you revert to an unlisted nasal code?  

Thanks!


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## FTessaBartels

*Still global*

Whether this was planned or not, it is still global to the original procedure for treating the fracture.  

F Tessa Bartels, CPC


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## Candice_Fenildo

It is still part of the 90 day global.


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## sarahlevi81@gmail.com

*Nasal Packing Removal*

Patient initially had a Epistaxis and packing was placed in the ED. Now patient is in the office to have the packing removed by a provider outside of the ED.  What is the code to capture the packing removal?
Thanks!


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