| Clinical Indicators
Septoplasty
| Procedure |
CPT |
FUD |
| Septoplasty or submuccous resection, with or
without cartilage scoring, contouring or replacement with graft |
30520 |
90 |
Indications
1. History...one or more required
| a) |
Nasal airway obstruction or difficult nasal breathing causing
any of the following: mouth breathing; snoring; sleep apnea; or recurrent sinus
infections. |
| b) |
Frequent nosebleeds. |
| c) |
Atypical facial pain of nasal origin. Positive response to
topical anesthetic, where deformed septum contacts a turbinate, supports but
may not prove septal cause. |
| d) |
Asymptomatic deformity that prevents surgical access to other
intranasal or paranasal areas, e.g., sinuses, turbinates. |
2. Physical Examination... all appropriate findings required.
| a) |
Description of complete intranasal exam. |
| b) |
Document absence of nasal polyps, tumors, turbinate hypertrophy
or other causes of obstruction. |
| c) |
Identification of known or suspected bleeding site if the
purpose of surgery is to control epistaxis. |
| d) |
Identification of sinus that is recurrently infected if the
purpose of surgery is to control disease. |
| e) |
Description of nasopharynx, oropharynx, hypopharynx, and larynx
if purpose of surgery is to treat sleep apnea or snoring. |
3. Tests... optional
| a) |
Nasal impedance (rhinometry). |
| b) |
Rhinomanometry. |
| c) |
Nasal endoscopy. |
Postoperative Observations
| 1. |
Bleeding? |
| 2. |
Pain? |
| 3. |
Packing or internal splint optional--is it in desired
location? |
Outcome Review
1. One Week
| a) |
Healing--Did patient require treatment for bleeding, septal
hematoma, or infection? |
2. Beyond One Month
| a) |
Presenting problem--Is it (see history) improved? |
| b) |
Status of septum--Is septal configuration desirable? Is there a
perforation? |
Associated ICD-9 Diagnostic Codes
| 470 |
Deviated nasal septum |
| 738.0 |
Acquired congenital deformity of nose |
| 748 |
Choanal atresia |
| 748.1 |
Other congenital anomalies of nose |
| 754.0 |
Congenital musculoskeletal deformities of skull,
face, and jaw |
| 781.1 |
Disturbances of taste and smell |
| 784.7 |
Epistaxis |
| 802 |
Closed fracture nasal bones |
| 802.1 |
Open fracture nasal bones |
Additional Information
Assistant Surgeon -- N
Supply Charges -- N
Prior Approval -- N
Anesthesia Code(s)
00160
Patient Information
Septoplasty is an operation to correct a deformity of the partition between
the two sides of the nose. The usual purpose is to improve breathing, but it
may also be required to permit adequate examination of the inside of the nose
for treatment of polyps, inflammation, tumors, or bleeding. When the nasal
septum is deformed, there is no medicine that will cause it to be straightened,
so surgery is the only solution to this problem. The undesirable results that
may occur include a hole in the septum, failure to completely improve
breathing, postoperative bleeding (usually easy to control), nasal crusting,
and very rarely, a change in appearance.
Important Notice
The Clinical Indicators for Otolaryngology--Head and Neck Surgery are
guidelines only. In no sense do they represent a standard of care. The
applicability of an indicator for a procedure, and/or of the process or outcome
criteria, must be determined by the responsible physician in light of all the
circumstances presented by the individual patient. Adherence to these
guidelines will not ensure successful treatment in every situation.
The American Academy of Otolaryngology-Head and Neck Surgery, Inc.
emphasizes that these clinical indicators should not be deemed inclusive of all
proper treatment decisions or methods of care, nor exclusive of other treatment
decisions or methods of care reasonably directed to obtaining the same results.
© 2000 American Academy of Otolaryngology-Head and Neck Surgery. One
Prince Street, Alexandria, VA 22314.
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