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A secondary rhinoplasty, commonly known as revision rhinoplasty, is a surgical procedure aimed at correcting or improving the results of a previous rhinoplasty. This type of surgery is typically performed when the initial rhinoplasty did not achieve the desired aesthetic or functional outcomes. Prior to the procedure, the physician conducts a thorough evaluation of the previous surgery's results, which informs the surgical plan. The procedure can be executed using either a closed technique, where all incisions are made inside the nose, or an open technique, which involves an additional incision across the columella, the tissue that separates the nostrils. During the surgery, the physician carefully marks the skin of the nose, often using pre-operative photographs as a reference to guide the reshaping process. In the case of CPT® Code 30430, the focus is on a minor revision, specifically involving a small amount of work on the nasal tip. This may include reshaping the nasal tip to ensure it projects harmoniously from the dorsal bridge line. Techniques employed may involve the removal of cartilage using a shaver or the placement of a cartilage graft. Secondary rhinoplasty procedures frequently necessitate the use of cartilage grafts harvested from the patient's ear or rib to achieve the desired structural support and aesthetic outcome.
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The procedure is indicated for patients who have undergone a previous rhinoplasty and are seeking to correct or enhance the results. Specific indications may include:
The procedure for CPT® Code 30430 involves several key steps, which are detailed as follows:
After the procedure, patients are typically monitored for a short period to ensure stable recovery from anesthesia. Post-operative care instructions will be provided, which may include guidelines on managing swelling and bruising, as well as recommendations for pain management. Patients are advised to avoid strenuous activities and follow-up appointments are scheduled to monitor healing and assess the results of the revision. It is important for patients to adhere to the surgeon's instructions to optimize recovery and achieve the best possible outcome.
| Short Descr | REVISION OF NOSE | Medium Descr | RHINOPLASTY SECONDARY MINOR REVISION | Long Descr | Rhinoplasty, secondary; minor revision (small amount of nasal tip work) | Status Code | Restricted Coverage | 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) | 2 - Payment restriction for assistants at surgery does not apply 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) | P5E - Ambulatory procedures - other | MUE | 1 | CCS Clinical Classification | 28 - Plastic procedures on nose |
| 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.) | 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.) | 82 | Assistant surgeon (when qualified resident surgeon not available): the unavailability of a qualified resident surgeon is a prerequisite for use of modifier 82 appended to the usual procedure code 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 |
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| Pre-1990 | Added | Code added. |
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