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The CPT® Code 30462 refers to a specific type of rhinoplasty performed to address nasal deformities that arise as a result of congenital cleft lip and/or palate. This procedure is comprehensive, as it not only focuses on reshaping the external appearance of the nose but also includes columellar lengthening, which is essential for achieving proper nasal symmetry and function. The nasal deformity can vary in complexity, potentially affecting just the nasal tip or extending to involve the septum and the underlying bony structures of the nose. Prior to the surgical intervention, the physician conducts a thorough assessment, which includes taking photographs to aid in planning the surgical approach. The rhinoplasty can be executed through incisions made entirely within the nasal passages or through external incisions on the skin, depending on the specific needs of the patient. The procedure involves careful marking of the nasal skin, guided by the preoperative photographs, to ensure precision in reshaping the nose. The surgical steps include lengthening the columella, reshaping asymmetrical nasal alae, augmenting the nasal tip, and performing necessary septoplasty and osteotomies to correct any bony deformities. This multifaceted approach aims to enhance both the aesthetic and functional aspects of the nose, ultimately improving the patient's quality of life.
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The procedure described by CPT® Code 30462 is indicated for patients presenting with nasal deformities that are secondary to congenital cleft lip and/or palate. These deformities may manifest in various forms, including but not limited to:
The surgical procedure associated with CPT® Code 30462 involves several detailed steps to correct the nasal deformities. The process begins with the physician marking the skin of the nose, using preoperative photographs as a reference to ensure accuracy in reshaping. The columella, which is the tissue that separates the nostrils, is lengthened as necessary. This may involve the use of an alar flap and/or a cartilage graft harvested from the ear or another donor site. The next step includes reshaping the asymmetrical nasal alae to create a more balanced appearance. The nasal tip is then augmented to ensure it projects gracefully from the dorsal bridge line, enhancing the overall aesthetic of the nose.
Following these initial steps, the procedure continues with the performance of a septoplasty. The septum is incised, and a mucoperichondrial flap is opened to access the underlying cartilage and bone. Using specialized instruments such as shavers and chisels, the surgeon removes any excess cartilage and bone that contribute to the deformity. If necessary, the bony pyramid of the nose may be fractured and reshaped to correct any bony deformities. Cartilage grafts obtained during contouring can be utilized to support and reshape other areas of the nose, ensuring structural integrity and aesthetic appeal.
As the procedure progresses, the nasal septum is reshaped, and any additional cartilage or bone is removed as needed. If a cartilage graft is required, the surgeon may use cartilage from the septum or harvest it from the ribs or ear. If the septum is deviated, it is repositioned to the center of the nose to improve airflow and symmetry. Upon completion of the reshaping and reconstruction, the incision is meticulously closed, and splints may be placed inside the nose to maintain the position of the septum. Nasal packing may also be utilized to control any postoperative bleeding, ensuring a smooth recovery process.
After the completion of the rhinoplasty procedure coded under CPT® 30462, patients can expect a recovery period that may involve some swelling and bruising around the nose and eyes. It is essential for patients to follow postoperative care instructions provided by their physician, which may include the use of nasal splints or packing to support the newly positioned structures and control bleeding. Patients are typically advised to avoid strenuous activities and to keep their head elevated to minimize swelling. Follow-up appointments will be necessary to monitor healing and to remove any splints or packing as needed. The overall recovery time can vary, but patients should be prepared for a gradual improvement in both the function and appearance of their nose as they heal.
| Short Descr | REVISION OF NOSE | Medium Descr | RHINP DFRM COLUM LNGTH TIP SEPTUM OSTEOT | Long Descr | Rhinoplasty for nasal deformity secondary to congenital cleft lip and/or palate, including columellar lengthening; tip, septum, osteotomies | 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) | 2 - Payment restriction for assistants at surgery does not apply to this procedure... | Co-Surgeons (62) | 2 - Co-surgeons permitted and no documentation required if the two- specialty requirement is met. | 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) | P6C - Minor procedures - other (Medicare fee schedule) | MUE | 1 | CCS Clinical Classification | 28 - Plastic procedures on nose |
| 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.) | 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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| 1993-01-01 | Added | First appearance in code book in 1993. |
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