Otolaryngology Coding Alert

Question: I am looking for a CPT code for -endoscopic sphenopalatine artery ligation.- I can find codes for ethmoidal and maxillary but not for sphenopalatine. Would I use the unlisted code 30999?

Michigan Subscriber

Answer: You-ll code 30920 (Ligation arteries;internal maxillary artery, transantral) for the ligation of the sphenopalpatine artery. The sphenopalatine artery is a terminal branch of the maxillary artery -- it carries blood to the nose. A physician will sometimes clip off this artery in a patient who has a severe, posterior nosebleed that doesn't respond to more conservative treatment, such as packing and cautery.

You-ll code 784.7 (Epistaxis) to describe the nosebleed, and a payer is liable to want to see other techniques your ENT used to stop the bleeding and the patient's response to those treatments. If the patient has a defect in her ability to clot  lood, you-ll code that diagnosis, too. For instance, if the patent has coagulopathy from liver disease, you-d code 286.7 (Acquired coagulation factor deficiency) to bolster the case for the procedure.