Don't have a TCI SuperCoder account yet? Become a Member >>

Regular Price: $24.95

Ask An Expert Starting at $24.95
Have a medical coding or compliance question? Don’t sacrifice your valuable time to endless research. Choose Ask an Expert to get clear answers from the TCI SuperCoder team. And here’s a tip for the budget-conscious: Select the 12-question pack to get the best rate per question!

Browse Past Questions By Specialty

+View all

What does CPT code 21335 include?

Marla Posted Fri 21st of December, 2012 20:24:08 PM

'Does CPT code 21335 include internal fixation? My physician dictates open reduction nasal fracture (did not do internal fixation) with septoplasty and am trying to figure out how to code this.'

SuperCoder Answered Fri 21st of December, 2012 20:46:33 PM

If procedure 21335 (open treatment of nasal fracture; with concomitant open treatment of fractured septum) is coded, the operative report should not say that the physician performed an open reduction of a nasal fracture and a septoplasty, but rather a septal repair or septal reduction because the reference to septoplasty will raise eyebrows when it is reviewed or audited.

The documentation also should include the correct diagnosis codes for the procedure in question. Associated ICD-9 codes vary among the different procedures, but all include the following:

470deviated nasal septum
802.0nasal bones, closed fracture
802.1nasal bones, open fracture

21335-Physicians perform open nasal fracture treatment when they are unable to reduce a patient's fracture externally. The surgery requires an incision into the nose to visualize the nasal and septal fractures and repair them.

Physician Responsibility
The physician makes an incision over the fracture and into the cartilage to visualize the bone. He exposes the bone segments, and, using surgical tools, moves the fracture bone, cartilage, and/or bone fragments back into the appropriate positions. He then elevates any bone fragments into position and inserts fine wires to keep the bones in position, often using a minidrill to create holes in the bone to anchor the wires. The physician reduces the fractured septum into place, typically placing sutures into the septum to hold it in position. The physician closes the incision in layers.

There is no associated fracture of septum. Hence 21325 along with 30520 will be coded. But

Code 21325 is a column 2 code for 30520, These codes cannot be billed together in any circumstances.
Code 21325 is bundled into code 30520 Code 21325 cannot be billed with 30520.

Hence in the above case only septoplasty 30520 will be coded.

Related Topics