{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,17]],"date-time":"2026-05-17T14:07:43Z","timestamp":1779026863569,"version":"3.51.4"},"reference-count":23,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T00:00:00Z","timestamp":1778716800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The Cleft Palate Craniofacial Journal"],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate national billing patterns for adjunctive rhinoplasty during primary cleft lip repair and assess associated operative characteristics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Retrospective database review.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>American College of Surgeons Pediatric National Surgical Quality Improvement Program, 2016\u20132021.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients, Participants<\/jats:title>\n                    <jats:p>Patients undergoing primary cleft lip repair identified using current procedural terminology (CPT) codes 40700\u201340702, stratified by use of additional rhinoplasty codes (30400\u201330462).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interventions<\/jats:title>\n                    <jats:p>Primary cleft lip repair with or without adjunctive rhinoplasty coding.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Outcome Measure(s)<\/jats:title>\n                    <jats:p>Use of adjunctive rhinoplasty codes, operative and anesthesia times, surgeon specialty, patient characteristics, and temporal trends in coding.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 8836 patients, 32.9% (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u20092911) were billed adjunctive rhinoplasty codes, most commonly CPT 30460 (78.0%) and 30462 (16.2%). Cases billed with adjunct rhinoplasty codes were associated with longer operative (146.0 vs. 114.6\u2005min;\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u2009.001) and anesthesia times (208.8 vs. 172.4\u2005min;\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u2009.001), as well as a higher proportion of ASA class II patients (62.4% vs. 55.0%;\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u2009.001). Plastic surgeons performed most primary cleft lip repairs (85%) and were more likely to bill adjunct rhinoplasty codes (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u2009.013).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Nearly one-third of primary cleft lip repairs include adjunctive rhinoplasty codes. Although comprehensive primary codes exist, differences in interpretation rather than evolving practice patterns may exist. Given the ongoing undervaluation of craniofacial procedures and limited coding mechanisms, clearer guidance is needed to better align billing with contemporary cleft surgical practice.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10556656261449945","type":"journal-article","created":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T03:25:32Z","timestamp":1778815532000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Presence of Additional Rhinoplasty Codes in Primary Cleft Lip Repair: A National Review of 8836 Cases"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-2302-7013","authenticated-orcid":false,"given":"Adam B.","family":"Fleming","sequence":"first","affiliation":[{"name":"University of Mississippi Medical Center"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ashlie A.","family":"Elver","sequence":"additional","affiliation":[{"name":"University of Mississippi Medical Center"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura S.","family":"Humphries","sequence":"additional","affiliation":[{"name":"University of Mississippi Medical Center"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8332-2280","authenticated-orcid":false,"given":"Ian C.","family":"Hoppe","sequence":"additional","affiliation":[{"name":"University of Mississippi Medical Center"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2026,5,14]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1159\/000337464"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(09)60695-4"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-030-91920-7_46"},{"key":"e_1_3_2_5_2","first-page":"781","volume-title":"Comprehensive cleft care","author":"Kirschner RE","year":"2016","unstructured":"Kirschner RE, Adetayo OA, Losee JE. Lip adhesion. In: Losee JE, Kirschner RE, eds. Comprehensive cleft care. Vol 2. CRC Press; 2016:781\u2013791."},{"key":"e_1_3_2_6_2","first-page":"233","volume-title":"Comprehensive cleft care","author":"Hopper RA","year":"2016","unstructured":"Hopper RA, Al-Mufarrej F. Gingivoperiosteoplasty. In: Losee JE, Kirschner RE, eds. Comprehensive cleft care. Vol 2. CRC Press; 2016:233\u2013240."},{"key":"e_1_3_2_7_2","first-page":"112","article-title":"Correction of nasal deformities accompanying unilateral cleft lip","volume":"7","author":"Spira M","year":"1970","unstructured":"Spira M, Hardy SB, Gerow FJ. Correction of nasal deformities accompanying unilateral cleft lip. Cleft Palate J. 1970;7:112\u2013123.","journal-title":"Cleft Palate J"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1053\/joms.2001.25852"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/0003-9969(70)90122-6"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0000000000009924"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-198506000-00003"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0000000000009922"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0000000000010697"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1097\/SCS.0000000000003667"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1177\/10556656241304213"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1177\/10556656251338640"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1097\/SCS.0000000000006362"},{"key":"e_1_3_2_18_2","unstructured":"The National Correct Coding Initiative (NCCI). Centers for Medicare & Medicaid Services. Available at: https:\/\/www.cms.gov\/national-correct-coding-initiative-ncci#:\u223c:text=The%20Centers%20for%20Medicare%20%26%20Medicaid Part%20B%20and%20Medicaid%20claims (accessed: August 19 2024)."},{"key":"e_1_3_2_19_2","unstructured":"General Correct Coding Policies for Medicare National Correct Coding Initiative Policy Manual last updated 1\/1\/2024. Available at: https:\/\/www.cms.gov\/files\/document\/medicare-ncci-policy-manual-2024-chapter-1.pdf (accessed: August 19 2024)."},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1097\/SCS.0000000000006362"},{"key":"e_1_3_2_21_2","unstructured":"American College of Surgeons. Pediatric national surgical quality improvement program overview. Available at https:\/\/www.facs.org\/quality-programs\/pediatric-surgery\/pediatric-nsqip\/ (accessed December 4 2024)."},{"key":"e_1_3_2_22_2","unstructured":"Centers for Medicare & Medicaid Services Relative Value Files. Available at: https:\/\/www.cms.gov\/medicare\/payment\/fee-schedules\/physician\/pfs-relative-value-files (accessed: August 19 2024)."},{"key":"e_1_3_2_23_2","unstructured":"Pegg B. Otolaryngology coding: Take this advice for foolproof rhinoplasty claims. Codify by AAPC. April 30 2025. https:\/\/www.aapc.com\/codes\/coding-newsletters\/my-otolaryngology-coding-alert\/otolaryngology-coding-take-this-advice-for-foolproof-rhinoplasty-claims-179336-article\/rci?srsltid=AfmBOorNxedvhZLp5KdpE1XNTSwtXgIx1PJaLmBvk6tL2W2warM_eldH (accessed June 25 2025)."},{"key":"e_1_3_2_24_2","volume-title":"IBM SPSS Statistics for Windows, Version 29.0","author":"IBM Corp","year":"2022","unstructured":"IBM Corp. IBM SPSS Statistics for Windows, Version 29.0. 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