Epistaxis FAQs

Epistaxis is bleeding from the nose.  Most cases of epistaxis involve bleeding from the anterior portion of the nasal septum and can be managed with topical vasoconstricting medications and direct pressure.  In certain cases, additional medication, packing, and cautery may be required.  Bleeding from the posterior portion of the nose is less common but more challenging to manage.  This often requires special packing, subspecialty consultation, and in some cases admission.

30901- hemorrhage control, anterior, simple (limited cautery or packing)

30903- hemorrhage control, anterior, complex (extensive cautery or packing)

30905- hemorrhage control, posterior, any method, initial

30906- hemorrhage control, posterior, any method, subsequent

No, the epistaxis codes only apply to cases where cautery is used and/or packing is left in place.  The management of epistaxis otherwise falls under the E/M code group (99281-99285).

While the ultimate decision is up the treating clinician, complex hemorrhage control would include repeat attempts at cautery and/or packing.

Dissolvable material, non-dissolvable material, and inflatable devices

The epistaxis codes apply to cases of unliteral hemorrhage control.  If bilateral procedures are performed, additional documentation is needed.  The “50” modifier can be applied which refers to a bilateral procedure.  The preferred documentation varies by payer but can include a single epistaxis code and a 50 modifier or two epistaxis codes with the second containing a 50 modifier.  Alternatively, you could report two epistaxis codes and respective left/right modifiers.