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Otolaryngology Coding Alert

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Get Familiar With Your 'Unlisted' Options

Published on Thu Jun 18, 2015

You have several choices for each ENT anatomic site. 

Coders try to avoid using unlisted-procedure codes whenever possible, partly because payer reimbursement is often inconsistent, and partly because carriers – and coders – prefer more descriptive codes. Unlisted codes also often represent delayed payment and additional work for the coding and billing departments since the documentation and explanation of the unlisted procedure needs to be sent to the payer as opposed to sending a quick electronic claim which has a defined fee and is usually paid within 2 to 3 weeks.
 
Coders who focus on some specialties might only have one or two ‘unlisted procedure’ options, but that’s not the case for ENT coders. Keep this list handy so you’ll be prepared to make the right choice the next time your otolaryngologist needs to file one of these claims. 
 
For procedures related to the digestive system:
  • 42299 – Unlisted procedure, palate, uvula
  • 42699 – Unlisted procedure, salivary glands or ducts
  • 42999 – Unlisted procedure, pharynx, adenoids, or tonsils 
  • 43499 – Unlisted procedure, esophagus.  
For auditory procedures: 
  • 69399 – Unlisted procedure, external ear 
  • 69799 – Unlisted procedure, middle ear 
  • 69949 – Unlisted procedure, inner ear 
  • 69979 – Unlisted procedure, temporal bone, middle fossa approach. 
For respiratory-related procedures: 
  • 30999 – Unlisted procedure, nose 
  • 31299 – Unlisted procedure, accessory sinuses (note that this does not apply to only endoscopic procedures, but for unlisted procedures performed on the accessory sinuses via any approach)
  • 31599 – Unlisted procedure, larynx 
  • 31899 – Unlisted procedure, trachea, bronchi.

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