# Help with tonsillectomy & biopsy



## Jody Mortensen (Aug 7, 2009)

Can anyone help me with CPT code selection for the following:  The surgeon did a left tonsillectomy & removed 5mm of the right tonsil to biopsy.  Would I use CPT code 42826 with a 22 modifier since only a small portion of the right was removed, or 42826-Lt with a biopsy code for the right? Would the biopsy code be 42800-Rt.   Your help is greatley appreciated.

                                         Thank you
                                                   Jody Hecht


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## ciphermed (Aug 7, 2009)

There is guidance which indicates that tonsillectomy codes (42820-42836) are meant to represent bilateral procedures therefore mod -50 is inappropriate...in addition if performed unilaterally should be reported with mod -52 appended...

Does not appear to be correct to append mod-lt to 42826.

Whether or not the Bx on the right should be coded??? not sure

42826 with -52 already indicates that the procedure was reduced.

...hope this helps,


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## lissalea (Oct 15, 2013)

*Tonsil Biopsy*

Hi Jody~ I know this is about 4 years too late, but I was just searching for this myself.  I found on another website that the correct ICD-9 px code is 28.11 and when I crosswalked it, I came up with 42999.  I am hoping it doesn't get denied for unlisted 

Liss


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