Open Reduction of Old Nasal - Septal Fracture

[Stefanie]

I believe, since this isn't an acute injury, happening over 5 months prior to surgery, that the appropriate coding would be the 30520 - Septoplasty as there is obstruction etc. Could some one please confirm or advise. Thank you.

 

[kpfohl]

I've run into this many times. I queried my MD and he stated that a nasal fracture can be repaired after 90 days (or more) out from the date of injury. I asked my compliance officers to research and they replied "it?s going to be on a case by case basis whether 21335 or 30420 is billed. Due to the fact that there isn?t something in writing that states the codes are defined by a timeframe you are going to have to base the selection on the documentation and discussion with the physician. If he feels that he is correcting a healing fracture he should document that fact and bill 21335. The dx code V54.1X will indicate to the payer that this is a treatment of a healing traumatic fracture."