Basics of CPT code 30520

Septoplasty procedure has a separate CPT code, which is little tricky to use by medical coders. Mostly the diagnosis are related to the nose and nasal sinus region. Septoplasty (SEP-toe-plas-tee) is another surgical procedure to straighten the bone and cartilage dividing the space between your two nostrils (septum).

Reconstructive septoplasty is the surgical correction of defects and deformities of the nasal septum (partition between the nostrils) by altering, splinting or removing obstructive tissue while maintaining or improving the physiological function of the nose. CPT code 30520 is used to report Septoplasty exam.

The physician performs a septoplasty or submucous resection with or without cartilage scoring, contouring or replacement with a graft. The nasal septum is the cartilage partition that supports the nose and separates the two nasal passages. Septoplasty is performed to correct a severely deviated or dislocated septum that is obstructing the flow of air through the nose. It is typically performed by submucous resection, which involves making an incision inside the nostril and elevating the mucosa to expose the underlying bone and cartilage.

The nasal septum is then reshaped. Cartilage and bone are removed as needed including any spurs. If a cartilage graft is required, it is usually created using cartilage that has been removed from the septum. If the septum is deviated it is repositioned to the center of the nose. Upon completion of the procedure, the incision is closed and splints placed inside the nose as needed to maintain the position of the septum. Nasal packing may also be used to control bleeding.

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Code description of CPT code 30520

30520 – Septoplasty or submucous resection, with or without cartilage scoring, contouring or replacement with graft

In this exam, the physician reshapes the nasal septum, correcting airway obstruction. Topical vasoconstrictive agents are applied to shrink the blood vessels and local anesthesia is injected in the nasal mucosa. The physician makes a vertical incision in the septal mucosa and elevates the mucoperichondrium from the septal cartilage. The deviated portion of the bony and cartilaginous septum is excised or augmented by grafting.

Local grafts from adjacent nasal bones and cartilage are not reported separately. If the cartilaginous septum remains bowed, partial or full-thickness incisions are made in the cartilage to straighten the septum. Excess cartilage is excised from the bone-cartilage junction. Incisions are closed in single layers. Transseptal sutures are placed. Septal splints may support the septum during healing.

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CPT code 30520 has a global period of 90 days. While 30140 has ‘0’ days global period.

ICD-10 Supporting medical necessity for  Procedure code 30520

J32.0-J32.9 Chronic sinusitis

J34.0 Abscess, furuncle and carbuncle of nose

J34.1 Cyst and mucocele of nose and nasal sinus

J34.2 Deviated nasal septum

J34.81-J34.89 Other specified disorders of nose and nasal sinuses

Q67.4 Other congenital deformities of skull, face and jaw

R04.0 Epistaxis

S02.2XXA-S02.2XXS Fracture of nasal bones

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RVU and Fees for CPT code 30520

Additional Code Information for CPT code 30520

PC/TC Indicator (26):                   0 = Physician Service Codes
Multiple Procedures (51):             2 = Standard payment adjustment rules for multiple procedures apply
Bilateral Surgery (50):                   0 = 150% payment adjustment for bilateral procedures does not apply
Physician Supervision:                  09 = Concept does not apply
Assistant Surgeon (80,82):             1 = Statutory payment restriction for assistants at surgery applies to this procedure
Co-Surgeons (62):                            0 = Co-surgeons not permitted for this procedure
Team Surgery (66):                          0 = Team surgeons not permitted for this procedure
Diagnostic Imaging Family:           99 = Concept does not apply