Otolaryngology Coding Alert

Question: What is the proper code for a septoplasty with correction of nasal valve deformity with bilateral cartilage grafts?

Lorrie Matzas, Office Manager
Dr. G.J. Pollack, NY

Answer: If there was no nasal valve deformity that required correction, 30520 (septoplasty or submucous resection, with or without cartilage scoring, contouring or replacement with graft) would be the only code used because it includes both the obtaining and placing of the grafted material, says Randa Blackwell, a coding specialist with the Department of Otolaryngology at the University of Maryland in Baltimore.

Correcting a nasal valve deformity usually involves a bony reconstruction, however, and depending on how extensive that is, the correct code could be a functional rhinoplasty (30420, rhinoplasty, complete, including major septal repair), Blackwell says. Because this code does not include obtaining the grafts, the appropriate graft code (depending on where the graft was obtained) should be used.

Otolaryngologists should provide documentation (including photographs, which can be very effective) to show the procedure was medically necessary because rhinoplasties often are denied as cosmetic.