# I could use your help please



## kdm (Apr 5, 2009)

I not sure which codes to use on this one.

Preoperative Diagnosis:  An 8 mm internal nasal mass on the medial aspect of the lower lateral cartilage on the left side

Postoperative Diagnosis: Concavity in th cartilage of the lower lateral of cartilage on the left side with no external deformity, but creating a 8 mm internal nasal deformity

Operation Performed: Division and suturing of left lower lateral cartilage concavity, appearing as internasal mass on that side

The internasal packing was removed and  intercartilage marginal performed in the left side.  The dissection was taken superiorly in the direction of the mass it was immediately apparent that what was felt to be a mass was an 8 mm concavitiy in the lower lateral cartilage.  This was dissected free medially and laterally and the then divided in the midline so it could assume a straight position in contour with the remaining lower laterally cartilage.  Once this was determined, the cartilage was sutured into place and this area re-palpated with absence of the previously-noted-8mm internal nasal deformity in the left.  

Any help would be most appreciated

Thanks, Kim


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## jackjones62 (Apr 11, 2009)

Check out CPT 30465; by what I read it sounds like a nasal valve collapse of sorts, where the cartilage weakens causing internal nasal deformities: CPT 30465 covers various techniques that are used to repair this deformity, such as spreader graft, suturing, etc...  pay attention to the parentheticals, because it was done unilaterally you would have to use modifier 52.

The Coding Companion has a good descriptive if you have access, if not, let me know, would be happy to get it to you.  

Jennifer
ENT CT


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## kdm (Apr 14, 2009)

*yes*

Thank you Jenifer,  I have looked at that code but wasn't sure.  This was the first time I had ever seen this.    I don't know know what the coding companion is but would love to have access to it.  How does that work
Thanks, Kim


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## jackjones62 (Apr 16, 2009)

Hi Kim, The "Coding Companion" is a book put out by INGENIX, it provides narratives, anatomical diagrams, coding tips, RVU's, globals, ICD9 codes that correlate and CCI Edits........Basically, it's a wonderful tool (a bit pricey, but well worth it).

The Coding Companion is available for most specialites, we utilize the ENT/Allergy/Pulmonology and Neurology.  If you want to provide me with your email address, I would be happy to scan CPT 30465 page and send it to you.

Jennifer
ENT CT


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