Summary & Overview
CPT 30540: Intranasal Repair of Choanal Atresia
CPT code 30540 identifies the intranasal surgical repair of choanal atresia, a condition in which the choanae are blocked, limiting nasal breathing. The code captures an intranasal approach where instruments are passed through the nostrils to re-establish the nasal airway. Nationally, this code is relevant for pediatric and otolaryngology surgical care, operating room resource planning, and payer coverage determinations for corrective airway procedures.
Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context for the procedure, typical sites of service, and the common payer landscape affecting coverage and billing practice. The publication summarizes common modifiers and service-line considerations, offers benchmarking context where available, and explains how the code is used in claims to represent intranasal choanal atresia repair.
This summary is intended for clinicians, coding professionals, and payer policy analysts seeking a clear, national-level reference on CPT code 30540, procedural context, and the payer mix typically involved in reimbursement and case management.
Billing Code Overview
CPT code 30540 describes the surgical repair of intranasal choanal atresia, a congenital or acquired blockage of the choana that impedes nasal breathing. The procedure is performed via an intranasal approach, with surgical instruments inserted through the nostrils to restore patency of the choanal airway.
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Service type: Surgical repair of nasal airway (intranasal choanal atresia repair)
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Typical site of service: Ambulatory surgical center or hospital operating room with nasal endoscopic capability
Clinical & Coding Specifications
Clinical Context
A typical patient is an infant or older child presenting with nasal airway obstruction, persistent cyclical cyanosis, feeding difficulty, or chronic unilateral nasal discharge. In neonates, bilateral choanal atresia causes respiratory distress and requires urgent evaluation; in older children or adults, unilateral atresia presents with chronic congestion and sinusitis. Workup includes nasal endoscopy and CT of the paranasal sinuses to define bony versus membranous atresia and laterality. The procedure 30540 is performed under general anesthesia via an intranasal approach: the surgeon uses endoscopic visualization and intranasal instruments to create or enlarge the choanal opening, remove the atretic plate, and may place stents or perform mucosal flaps to reduce restenosis. Typical intraoperative workflow includes induction of anesthesia, nasal decongestion and topical vasoconstrictors, endoscopic inspection, removal of atretic tissue with microdebrider or drill as indicated, hemostasis, and optional stent placement. Postoperative care includes nasal saline, short course topical steroid or antibiotic as indicated, follow-up endoscopy to assess patency, and possible revision if restenosis occurs. Typical site of service is an operating room in a hospital or ambulatory surgery center. Service type is a surgical, intranasal endoscopic repair of choanal atresia.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | Default/No modifier |