tci Outpatient Facility Coding Alert - 2016 Issue 4

Reader Question: Use Rhinoplasty Codes When Treating a Healed Fracture

Question: We submitted a claim with codes 21325 and 30520, but the payer denied 21325.  Can you explain? Indiana Subscriber Answer: Nasal fracture treatment codes such as 21325 (Open treatment of nasal fracture; uncomplicated) should be used when the physician treats an acute fracture, not an old or healed fracture. The rhinoplasty codes such as 30420 (Rhinoplasty, primary; including major septal repair) are more appropriate when treating a healed fracture. FYI: Many providers tend to want to stick with 21325 even with old or healed fractures because they are concerned about not getting paid for functional (non-cosmetic) rhinoplasty...

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