Summary & Overview
CPT 30915: Ethmoid Artery Ligation via Nasal Incision
CPT code 30915 describes surgical ligation of the ethmoid arteries via an incision in the lateral nasal cavity to control bleeding from the ethmoid region. Nationally, this procedure is relevant for management of refractory epistaxis or arterial hemorrhage that cannot be controlled by conservative or endoscopic measures. It represents a targeted vascular control operation within otolaryngology and facial/skull-base surgery.
Key payers in coverage discussions include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise clinical context for the procedure, expected sites of service, and which payers are commonly involved. The publication outlines available benchmarks, coding relationships, and policy considerations that affect billing and authorization for this surgical service.
The report provides practical reference material for billing and coding teams, compliance officers, and clinical planners: definitions of the service, likely clinical indications, payer presence in national coverage discussions, and guidance on where to find more detailed policy or reimbursement information. Data not available in the input is clearly noted where applicable.
Billing Code Overview
CPT code 30915 describes a surgical procedure in which the surgeon makes an incision in the lateral wall of the nasal cavity to access and ligate the ethmoid arteries. The procedure involves identifying the ethmoid arterial branches and securing them using clips or sutures to control epistaxis or arterial bleeding originating from the ethmoid region.
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Service type: Surgical arterial ligation of ethmoid arteries
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Typical site of service: Hospital operating room or ambulatory surgical center (nasal cavity/ethmoid region incision and arterial ligation)
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult with recurrent or severe posterior epistaxis originating from the sphenopalatine/ethmoid arterial branches that is not controlled by anterior nasal packing, topical vasoconstrictors, or endoscopic cautery. The patient presents to the emergency department or otolaryngology clinic with active bleeding, often after failed conservative measures, or with recurrent significant bleeding requiring definitive surgical control. Preoperative evaluation includes coagulation studies, review of antithrombotic medications, nasal endoscopy to localize the bleeding source, and informed consent discussing risks such as bleeding, infection, septal perforation, anosmia, and need for general anesthesia.
In the clinical workflow the patient is typically admitted or scheduled for an operating room procedure under general anesthesia. The otolaryngologist performs endoscopic or external exposure of the posterior nasal cavity, makes an incision in the lateral nasal wall to identify ethmoid arterial branches, and ligates or clips those vessels to stop hemorrhage. Postoperative care includes observation for recurrent bleeding, nasal packing or splints as needed, pain control, topical saline, and follow-up endoscopic assessment.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
50 | Bilateral procedure | Use when ligation is performed on both sides during the same operative session |