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The procedure described by CPT® Code 30920 involves the ligation of the internal maxillary artery through a transantral approach. This surgical intervention is primarily indicated for the management of severe epistaxis, or nosebleeds, that are unresponsive to conservative treatment methods. The internal maxillary artery is a significant vessel that supplies blood to the nasal cavity, and its ligation can effectively reduce or stop excessive bleeding. The transantral approach allows the surgeon to access the internal maxillary artery by making an incision in the buccal mucosa, which is the inner lining of the cheek. This method is particularly useful when other techniques for controlling nasal bleeding have failed, providing a direct route to the artery that can be ligated to achieve hemostasis. The procedure requires careful dissection and identification of anatomical structures to ensure that the correct artery is targeted while minimizing damage to surrounding tissues.
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The ligation of the internal maxillary artery is performed for specific clinical indications, particularly in cases of severe epistaxis that cannot be managed through less invasive methods. The following conditions may warrant this procedure:
The procedure for ligating the internal maxillary artery via a transantral approach involves several critical steps to ensure effective access and ligation of the artery.
After the ligation of the internal maxillary artery, post-procedure care is essential for optimal recovery. Patients may be monitored for any signs of continued bleeding or complications. Pain management and instructions for oral hygiene will be provided, as the surgical site is located in the oral cavity. Follow-up appointments may be scheduled to assess healing and ensure that the procedure has successfully resolved the epistaxis. Additionally, patients should be advised on activities to avoid during the recovery period to prevent strain on the surgical site.
| Short Descr | LIGATION UPPER JAW ARTERY | Medium Descr | LIGATION ARTERIES INT MAXILLARY TRANSANTRAL | Long Descr | Ligation arteries; internal maxillary artery, transantral | 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.) | 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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