Summary & Overview
CPT 21315: Closed Reduction of Nasal Bone Fracture
CPT code 21315 covers closed (non-incisional) reduction of nasal bone fractures, a common procedure performed to restore nasal form and airway function after trauma. Nationally, timely reduction of displaced nasal fractures can affect patient outcomes including breathing, cosmetic results, and the need for later reconstructive procedures. This code is relevant across emergency departments and ambulatory surgical centers where acute facial trauma is managed.
Key payers addressed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context for the procedure, expected sites of service, and the payer mix typically involved. The publication includes benchmark considerations, coding and billing context, and policy and coverage perspectives that affect authorization, bundling, and post-procedure care requirements.
The material provides clinicians, billing professionals, and policy analysts with actionable reference points: what CPT code 21315 represents, where it is commonly performed, and which major payers commonly cover the service. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 21315 describes a closed (non-incisional) reduction of a nasal bone fracture in which the provider manipulates the nose to realign bones and restore function and appearance. This procedure is typically performed to correct displaced nasal fractures that affect airway function or cosmetic contour.
Service Type: Fracture reduction / nasal manipulation
Typical Site of Service: Emergency department or outpatient ambulatory surgical setting, depending on timing, severity, and patient condition.
Clinical & Coding Specifications
Clinical Context
A typical patient is a 20–45-year-old adult who presents to the emergency department after blunt facial trauma (assault, fall, or sports injury) with nasal pain, deformity, epistaxis, and nasal airway obstruction. Initial evaluation includes history, external and intranasal exam, and facial radiographs or CT if indicated. If a closed (non‑open) nasal bone fracture is identified and reduction is appropriate, the provider performs 21315 — a closed manipulation of the nasal bones — typically in the ED, an ambulatory surgical center, or an outpatient clinic procedure room. Local or general anesthesia or conscious sedation may be used based on patient tolerance, timing from injury (commonly within 1–2 weeks), and concomitant injuries. Post-reduction assessment documents realignment, external splinting or internal packing as indicated, post‑procedure instructions, and follow-up with otolaryngology or plastic surgery within 1–2 weeks to confirm healing and cosmetic/functional outcomes.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
11 | Normally Used Service | Use for the usual, non‑distinct service when reporting the primary procedure without unusual circumstances. |
22 |