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The procedure described by CPT® Code 21335 refers to the open treatment of a nasal fracture that occurs alongside the open treatment of a fractured septum. This surgical intervention is necessary when there is a significant displacement of the nasal bones and the septum, which is the cartilage and bone structure dividing the nasal cavity. The open treatment approach involves making an incision along the nasal septum, allowing the physician to gain direct access to the fractured areas. This access is crucial for visualizing the fractured bone and cartilage, which is essential for effective realignment and stabilization. In uncomplicated cases, the physician employs tools such as forceps and nasal elevators to reposition the bones back into their proper alignment. However, in more complicated scenarios, additional incisions may be required, and some bone or cartilage may need to be excised to facilitate proper reduction. The stabilization of the fractures can involve the use of various internal fixation devices, including screws, plates, and wires. After the procedure, all incisions are meticulously closed, and external splints may be applied to provide additional support and stabilization during the healing process.
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The open treatment of nasal fractures with concomitant open treatment of fractured septum, as described by CPT® Code 21335, is indicated in the following scenarios:
The procedure for CPT® Code 21335 involves several critical steps to ensure proper treatment of the nasal and septal fractures:
Following the open treatment of nasal and septal fractures, patients can expect specific post-procedure care and considerations. It is essential to monitor for any signs of complications, such as infection or improper healing. Patients may experience swelling and discomfort in the nasal area, which can be managed with prescribed pain relief medications. Follow-up appointments are crucial to assess the healing process and ensure that the fractures remain properly aligned. The physician may provide specific instructions regarding activity restrictions, nasal care, and the use of any external splints to support recovery. Adhering to these guidelines is vital for optimal healing and restoration of nasal function.
| Short Descr | OPEN TX NOSE & SEPTAL FX | Medium Descr | OPEN TX NASAL FX W/CONCOMITANT OPTX FXD SEPTUM | Long Descr | Open treatment of nasal fracture; with concomitant open treatment of fractured septum | 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) | 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 |
| 22 | Increased procedural services: when the work required to provide a service is substantially greater than typically required, it may be identified by adding modifier 22 to the usual procedure code. documentation must support the substantial additional work and the reason for the additional work (ie, increased intensity, time, technical difficulty of procedure, severity of patient's condition, physical and mental effort required). note: this modifier should not be appended to an e/m service. | 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. | 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.) | AG | Primary physician | 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) | SG | Ambulatory surgical center (asc) facility service |
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| 2013-01-01 | Changed | Short Descriptor changed. |
| Pre-1990 | Added | Code added. |
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