Question Latera implant-30465

abarger

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Hello,

I'm having a hard time figure out how to correctly code the Nasal Valve repair our Dr. performs. He wants to use 30465. He says he uses the polymer implant because using cartilage-many times the nose will absorb the cartilage and the nose re-collapses. He does not want to use the 30999 code as he doesn't get paid for it, I just don't see any other way around it. The procedure is as follows:

I then directed my attention to the external nasal cavity. The polymer implant was loaded into its deployment device and was advanced to the tip of the device. I everted the left alar rim with a sharp 2-prong hook. The 16-gauge needle of the deployment device was used to penetrate the skin at the distal margin of the ala. The needle was advanced in a subcutaneous and then a submucosal plane along the inner surface of the alar cartilage addressing the lateral nasal wall. At the superior aspect of the alar cartilage, the needle was used to palpate the caudal edge of the upper lateral cartilage or lateral nasal wall. At this juncture, the skin hook was rotated down to provide inferior retraction and the deployment device was rotated down as well to conform with the plane of the upper lateral cartilage. The needle was then advanced through the intercartilaginous space and through the soft triangle beneath the skin overlying the upper lateral cartilage or lateral nasal wall and following the marked trajectory line I had done earlier with my skin scribe. With the bevel rotated down against the superior surface of the upper lateral cartilage, the needle was advanced in a subcutaneous plane over the nasal bone elevating the needle tip slightly to confirm the position of the tip advancement was stopped at the superior aspect of my skin marking I had placed earlier. Carefully depressing the plunger, the polymer implant was deployed with visible tenting of the skin over the nasal bones. Gentle finger pressure was used to hold the implant in place. The deployment device was carefully withdrawn and removed from the nose. The implant position was confirmed by palpation. There was no visible distortion of the skin over the nasal dorsum, but there was visible improvement of the patency of the nasal passage. The insertion site was inspected. There was no significant bleeding or evidence of protrusion of the proximal end of the implant. The procedure was then repeated to the contralateral side or the right side.

Is anyone else having the same issue with their Dr.?
 

shari1264

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I had this issue last year with an ASC that I do facility coding for. The surgeons stopped using the implant because 30999 is the correct CPT code to bill. I actually sent the surgeons a description of 30465 and they unanimously agreed that it would be wrong to bill using that code. They ultimately decided to stop using the implant unless the day comes that there is a procedure code for the implant.
 
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