Otolaryngology Coding Alert

Question: Which CPT code should I use for nasal valve suspension?


Wisconsin Subscriber

  Answer: You should report nasal valve suspension with 30465 (Repair of nasal vestibular stenosis [e.g., spreader grafting, lateral nasal wall reconstruction]).

Code 30465 describes repair of nasal valve stenosis, a condition in which the patient's nasal passage narrows. "Various surgical procedures for correction of nasal valve stenosis exist and most frequently involve the use of spreader grafts, but also include insertion of cartilage or plates, flaring sutures and suspension methods," states the article "Suspension Sutures for Nasal Valve Stenosis" available at www.surgeons.org. 

Suspension methods, such as the otolaryngologist in your example uses, include using a special type of stitch for nasal valve suspension. Because this procedure repairs nasal vestibular stenosis, 30465 appropriately describes the procedure.

Modifier alert: You should report 30465 when the otolaryngologist performs bilateral nasal valve suspension. If the physician does a unilateral repair, you should append modifier -52 (Reduced services) to 30465, states CPT's instruction note following 30465.

Remember to report the appropriate graft code (20900-20926, 21210) when the otolaryngologist obtains a graft, such as a tissue graft (20926, Tissue grafts, other [e.g., paratenon, fat, dermis]). When coding a graft with nasal valve suspension, multiple-procedure rules don't apply - 21210 is the exception. So you shouldn't append modifier -51 (Multiple procedures) to the graft code.