CPT 30220 Silastic Button Prosthesis Reimbursement

CPT code 30220 denotes the surgical insertion of a silastic button prosthesis to repair a tear in the nasal septum. This procedure addresses structural defects of the septum that can cause nasal obstruction, epistaxis, or mucosal irritation. The code is relevant nationally for otolaryngology surgical billing and for payers managing coverage of reconstructive nasal procedures involving prosthetic implants.

Key payers included in the analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise description of the clinical intent of the procedure, typical settings where it is performed, and the payer landscape relevant to reimbursement and coverage review. The publication also outlines benchmarks and coding considerations, summarizes common modifiers that may apply, and situates the procedure within related otolaryngology service lines.

This summary is intended to help coding, billing, and policy professionals quickly understand what CPT code 30220 represents, where the procedure is typically performed, and which major payers are commonly associated with claims for this service. Data not available in the input are noted where applicable.

Billing Code Overview

CPT code 30220 describes the surgical insertion of a silastic button prosthesis to repair a tear of the nasal septum. The procedure involves placing a small silicone-based (silastic) device to support and close a septal defect caused by trauma, perforation, or surgical complication.

Service type: Surgical repair of nasal septal tear using implantable prosthesis
Typical site of service: Ambulatory surgical center or hospital operating room

Clinical Context

A 34-year-old patient presents to an otolaryngology clinic with a symptomatic septal perforation following prior septoplasty and chronic nasal crusting, epistaxis, and whistling during breathing. Conservative measures (saline irrigations, topical emollients) failed to control symptoms. The surgeon plans insertion of a silastic button prosthesis under local anesthesia with sedation or general anesthesia depending on patient tolerance. Preoperative workflow includes history and physical, nasal endoscopy to assess perforation size and location, informed consent documenting risks (bleeding, infection, prosthesis extrusion), and marking of the prosthesis size. The procedure is typically performed in an outpatient ambulatory surgical center or hospital outpatient department. Postoperative care includes topical antibiotics or saline, short-term analgesia, follow-up nasal endoscopy to assess prosthesis position, and education on avoiding nasal trauma and forceful nose blowing.

Coding Specifications

Modifier	Description	When to Use
`00`	No modifier/unspecified	Rarely used; placeholder when no other qualifier applies.
`51`	Multiple procedures	When this procedure is reported on the same date with other unrelated CPT procedures by the same provider.

Taxonomy Code	Specialty	Notes
207P00000X	Otolaryngology	Primary specialty performing septal prosthesis insertion.
208D00000X	General Surgery	May perform nasal procedures in some settings.
163WL0400X	Plastic Surgery	Rhinoplasty and septal repair specialists who may manage perforations.
206E00000X	Allergy & Immunology	Rarely involved; included for settings with nasal restorative procedures.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`J34.2`	Deviated nasal septum	May coexist and contribute to septal disease; often evaluated when addressing perforation.
`J34.89`	Other specified disorders of nose and nasal sinuses	Includes symptomatic septal perforations not otherwise classified.
`R04.0`	Epistaxis	Common presenting symptom leading to discovery of septal perforation.
`K11.7`	Hyposalivation and dry mouth	Contributes to nasal crusting and mucosal breakdown, exacerbating perforations.
`T81.4XXA`	Infection following a procedure, initial encounter	Relevant if perforation resulted from prior surgical complication leading to need for prosthesis.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`30130`	Submucous resection of septum (septoplasty)	Performed before or instead of prosthesis placement for septal deformity or to prepare margins.
`30930`	Excision or reconstruction of nasal mucosa for septal perforation, large or recurrent	Alternative or adjunctive surgical repair for larger perforations rather than prosthesis.
`31231`	Nasal/sinus endoscopy, diagnostic, unilateral or bilateral (separate procedure)	Used preoperatively and postoperatively to assess perforation and prosthesis position.
`99070`	Supplies and materials provided by physician over and above those usually included with the service (eg, for prosthesis)	May be used to report the silastic button supply if payer allows.

OpenPayer

Summary & Overview

CPT 30220: Silastic Button Prosthesis for Nasal Septum Tear Repair