Reporting Rhinoplasty with Septal Repair

Question:

Our physician frequently performs septorhinoplasty procedures to address severe septal deviation and, in some cases, nasal valve collapse. He typically bills CPT 30420, which includes major septal repair. However, we are seeking clarification due to conflicting references: the Coders’ Desk Reference describes 30420 as involving nasal bone fracture and repositioning, and other sources suggest it is primarily a cosmetic procedure. Given that our physician’s intent is functional, improving airway obstruction, does CPT 30420 still apply? Is reshaping of the nasal tip or dorsal hump required to justify 30420, or would CPT 30520 (septoplasty) be more appropriate in these cases?

Answer:

The Coders’ Desk Reference includes an introductory disclaimer stating that each procedural description represents one possible method of performing the service and should not be interpreted as the only acceptable approach. Its narrative examples are intended to illustrate common surgical techniques, not to define the required components of the CPT code itself. If both a rhinoplasty and septoplasty are performed, report 30420 to capture the combined procedure, as this code includes major septal repair. Ensure that the appropriate functional or reconstructive diagnosis is reported on the claim to support medical necessity.

*This response is based on the best information available as of 02/05/26.