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ICD-10 Guide
DiagnosesNasal Septal Perforation

Nasal Septal Perforation

ICD-10 Coding for Nasal Septal Perforation(J34.89, T66.9XXA)

PRIMARY SPECIALTYOtolaryngology
COMPLEXITYHigh
LAST UPDATED09/15/2025
Sam Tuffun, PT, DPT
Physical Therapist | Medical Coding & Billing Contributor

Diagnosis Overview

What is Nasal Septal Perforation?
Essential facts and insights about Nasal Septal Perforation

Key Clinical Considerations:

  • Nasal obstruction or congestion
  • Nasal discharge (purulent or clear)
  • Epistaxis (nosebleeds)
  • Whistling sound during breathing
  • Key diagnostic tests include nasal endoscopy and imaging studies
  • Physical exam findings may include visible perforation on nasal examination

Clinical Information

Clinical Criteria & Documentation Requirements

  • Required documentation elements include patient history, symptoms, and examination findings
  • Specific coding terminology includes 'perforation', 'septal defect', and 'nasal obstruction'
  • Documentation examples: 'Patient presents with nasal obstruction and visible septal perforation on examination.'

Coding Guidelines

Usage Guidelines & Examples

  • Usage guidelines emphasize the need for clear documentation of symptoms and impact on daily activities.
  • Common errors include misclassifying the condition as a simple nasal obstruction without noting the perforation.

Code Exclusions

Important Exclusions

  • Excluded conditions include nasal polyps and chronic rhinosinusitis without perforation.
  • Alternative codes may include those for nasal trauma or other structural nasal abnormalities.

Related ICD-10 Codes

Primary Codes
J34.2
Nasal septal perforation
Ancillary Codes
CPT 30220
CPT 30630
Differential Codes
J34.2

Related CPT Codes

CPT codes will be available in a future update.

Specialty Focus

Primary Specialty

Otolaryngology

Specialty Applications

  • Patient populations include those with a history of nasal trauma, drug use, or chronic nasal conditions.
  • Clinical settings include outpatient otolaryngology clinics and emergency departments.

Coding Complexity

High Complexity

This diagnosis requires careful attention to:

  • Comprehensive clinical documentation
  • Accurate code selection based on clinical criteria
  • Proper exclusion considerations
  • Specialty-specific coding guidelines

Documentation

Documentation Templates

Billing Information

Billing Considerations

  • Ensure proper documentation for billing
  • Verify code specificity requirements
  • Check for any additional codes needed
  • Review payer-specific guidelines

Common Issues

  • Insufficient clinical documentation
  • Incorrect code selection
  • Missing supporting diagnoses
  • Timing and frequency documentation

Frequently Asked Questions

Documentation requirements?

Document the size, location, and symptoms associated with the perforation.

Billing considerations?

Ensure accurate coding to reflect the severity and impact on patient function.