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The CPT® Code 21330 refers to the open treatment of a complicated nasal fracture, which involves the use of internal and/or external skeletal fixation. This procedure is indicated when a nasal fracture is not straightforward and requires more extensive intervention than simpler cases. The process begins with the physician making an incision along the nasal septum to gain access to the fractured bone(s). This incision allows for direct visualization of the injury, which is crucial for effective treatment. In cases classified as complicated, additional incisions may be necessary to adequately address the fracture. The physician employs specialized instruments such as forceps and nasal elevators to carefully reposition the fractured bones back into their proper alignment. In some instances, portions of the bone may need to be excised to facilitate this reduction. Once the bones are properly aligned, the physician may use various fixation devices, including screws, plates, and/or wires, to stabilize the fracture internally. After the fixation is complete, all incisions are meticulously closed to promote healing. Additionally, external splints may be applied to provide further stabilization and support during the recovery process.
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The open treatment of a complicated nasal fracture, as described by CPT® Code 21330, is indicated in the following scenarios:
The procedure for the open treatment of a complicated nasal fracture involves several critical steps:
After the open treatment of a complicated nasal fracture, patients can expect a recovery period that may involve monitoring for any complications. Post-procedure care typically includes instructions for managing pain, keeping the surgical site clean, and avoiding activities that could stress the nasal structure. Follow-up appointments are essential to ensure proper healing and to assess the stability of the fracture. The use of external splints may be recommended for a specified duration to aid in the healing process.
| Short Descr | OPEN TX NOSE FX W/SKELE FIXJ | Medium Descr | OPEN TX NASAL FX COMP W/INT&/XTRNL SKELETAL FI | Long Descr | Open treatment of nasal fracture; complicated, with internal and/or external skeletal fixation | Status Code | Active Code | Global Days | 090 - Major Surgery | 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) | 0 - 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). | 58 | Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78. | 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. | 78 | Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, see modifier 76.) | 80 | Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s). | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | GC | This service has been performed in part by a resident under the direction of a teaching physician | LT | Left side (used to identify procedures performed on the left side of the body) | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service |
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| 2013-01-01 | Changed | Description Changed |
| Pre-1990 | Added | Code added. |
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