Otolaryngology Coding Alert

Question: The surgeon completed intercartilaginous placement of septal cartilage for nasal valve stenting. How should we report this?

Maine Subscriber

Answer: Two codes could possibly be appropriate, depending on the circumstances. If the provider performed the procedure because of nasal vestibular stenosis, the correct code is 30465 (Repair of nasal vestibular stenosis [e.g., spreader grafting, lateral nasal wall reconstruction]). The code represents a bilateral procedure, so append modifier 52 (Reduced services) for a unilateral procedure.

Nasal vestibular stenosis occurs due to congenital defects, trauma, or previous stenosis surgery leading to breathing problems.

Your other possible choice is 30520 (Septoplasty or submucous resection, with or without cartilage scoring, contouring or replacement with graft). Surgeons most often perform septoplasty due to a deviated septum which can be either C–shaped, S–shaped, or a cartilaginous deviation.

Bottom line: Check the operative report for more details about exactly what your physician did and the associated diagnoses. For example, diagnoses J34.0 (Abscess, furuncle and carbuncle of nose) or J34.1 (Cyst and mucocele of nose and nasal sinus) can be associated with nasal vestibular stenosis. That will help you choose between 30465 and 30520.