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The CPT® Code 21315 refers to the closed treatment of a nasal bone fracture with manipulation, specifically without stabilization. The nasal bones are two small, elongated bones that form the bridge of the nose, projecting from the frontal processes of the maxilla and the nasal process of the frontal bone, and they meet at the midline of the face. When a fracture occurs in this area, it is essential to assess the severity of the injury through separately reportable radiographs of the nasal bones. In the procedure described by code 21315, a minimally displaced nasal fracture is addressed through a reduction technique. This involves the use of an elevator, which is inserted into the nasal cavity to manipulate the depressed fragments back into their proper position. The surgeon applies outward pressure with the elevator while simultaneously using their thumb to exert counterpressure on the outside of the nose, ensuring that the bones are realigned correctly. Alternatively, forceps may be employed to grasp the displaced bone and reposition it to restore anatomical alignment. After the reduction process, the septum is evaluated to confirm that it is also properly aligned. To verify the success of the reduction, additional radiographs are obtained. Finally, internal packing is applied to manage any bleeding that may occur as a result of the manipulation. This procedure is crucial for restoring the structural integrity of the nasal bones and ensuring proper healing without the need for stabilization methods, which are addressed in the subsequent code 21320.
© Copyright 2025 Coding Ahead. All rights reserved.
The closed treatment of a nasal bone fracture with manipulation, as described by CPT® Code 21315, is indicated for patients who present with a minimally displaced nasal fracture. This procedure is typically performed when the fracture does not require stabilization and can be effectively managed through manipulation alone. The indications for this procedure may include:
The procedure for CPT® Code 21315 involves several key steps to ensure the effective treatment of a nasal bone fracture. The steps are as follows:
After the closed treatment of a nasal bone fracture with manipulation, patients may require specific post-procedure care to ensure proper healing and recovery. It is important to monitor for any signs of complications, such as excessive bleeding or misalignment of the nasal bones. Patients may be advised to avoid activities that could impact the healing process, such as contact sports or any actions that may put pressure on the nose. Follow-up appointments are typically scheduled to assess the healing progress and to obtain further radiographs if necessary. The internal packing used during the procedure may need to be removed after a specified period, depending on the surgeon's assessment of the patient's condition. Overall, proper post-procedure care is essential for achieving optimal outcomes following the manipulation of a nasal bone fracture.
| Short Descr | CLSD TX NSL FX MNPJ WO STBLJ | Medium Descr | CLOSED TX NASAL BONE FX W/MNPJ W/O STABILIZATION | Long Descr | Closed treatment of nasal bone fracture with manipulation; without stabilization | Status Code | Active Code | Global Days | 000 - Endoscopic or Minor Procedure | PC/TC Indicator (26, TC) | 0 - Physician Service Code | 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 Supervisions | 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 | APC Status Indicator | Hospital Part B services paid through a comprehensive APC | ASC Payment Indicator | Surgical procedure on ASC list in CY 2007; payment based on OPPS relative payment weight. | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P5B - Ambulatory procedures - musculoskeletal | MUE | 1 | CCS Clinical Classification | 144 - Treatment, facial fracture or dislocation |
| 51 | Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 54 | Surgical care only: when 1 physician or other qualified health care professional performs a surgical procedure and another provides preoperative and/or postoperative management, surgical services may be identified by adding modifier 54 to the usual procedure number. | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | 76 | Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | 79 | Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.) | GC | This service has been performed in part by a resident under the direction of a teaching physician | GV | Attending physician not employed or paid under arrangement by the patient's hospice provider | GW | Service not related to the hospice patient's terminal condition | LT | Left side (used to identify procedures performed on the left side of the body) | SG | Ambulatory surgical center (asc) facility service | X4 | Episodic/focused services: for reporting services by clinicians who provide focused care on particular types of treatment limited to a defined period and circumstance; the patient has a problem, acute or chronic, that will be treated with surgery, radiation, or some other type of generally time-limited intervention; reporting clinician service examples include but are not limited to, the orthopedic surgeon performing a knee replacement and seeing the patient through the postoperative period | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure |
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| 2022-01-01 | Changed | Code description changed. |
| 2013-01-01 | Changed | Short Descriptor changed. |
| Pre-1990 | Added | Code added. |
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