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The procedure described by CPT® Code 30915 involves the ligation of the ethmoidal arteries, which are critical blood vessels located in the nasal region. This surgical intervention is primarily performed to manage severe epistaxis, commonly known as a nosebleed, that cannot be effectively controlled through less invasive methods. The ligation process entails a careful surgical approach, typically initiated through an incision made between the inner canthus of the eye and the midline of the nose. This precise location allows the physician to access the ethmoidal arteries directly. During the procedure, the periosteum, which is the connective tissue that covers the bones, is incised and elevated to expose the underlying structures. The surgeon identifies the suture line between the ethmoid and frontal bones at the superior aspect of the lacrimal bone, which is crucial for navigating the surgical field. Following this, the periosteum is further elevated off the medial wall of the orbit along the identified suture line. The anterior and posterior ethmoid arteries are then located and ligated using sutures or vascular clips, effectively reducing blood flow to the area and addressing the source of the bleeding. This procedure is essential for patients experiencing uncontrollable nosebleeds, providing a definitive solution when other treatment options have failed.
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The ligation of the ethmoidal arteries, as described by CPT® Code 30915, is indicated for specific clinical scenarios where other methods of controlling epistaxis have proven ineffective. The primary indication for this procedure is:
The procedure for ligating the ethmoidal arteries involves several critical steps to ensure effective treatment of severe epistaxis. Each step is designed to provide the surgeon with the necessary access and visibility to perform the ligation safely and effectively.
After the ligation of the ethmoidal arteries, patients may require specific post-procedure care to ensure proper healing and recovery. It is essential to monitor for any signs of complications, such as continued bleeding or infection. Patients are typically advised to avoid strenuous activities and to follow any specific instructions provided by the healthcare provider regarding wound care and follow-up appointments. The expected recovery period may vary depending on individual circumstances, but close observation is crucial to ensure that the procedure has effectively resolved the issue of severe epistaxis.
| Short Descr | LIGATION NASAL SINUS ARTERY | Medium Descr | LIGATION ARTERIES ETHMOIDAL | Long Descr | Ligation arteries; ethmoidal | 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) | P5E - Ambulatory procedures - other | MUE | 1 | CCS Clinical Classification | 27 - Control of epistaxis |
| 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.) | 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) | RT | Right side (used to identify procedures performed on the right side of the body) |
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| 2011-01-01 | Changed | Short description changed. |
| Pre-1990 | Added | Code added. |
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