Otolaryngology Coding Alert

Reader Question:

42300-42305 Contain More Than You Think

Question: Which codes should I use for incision and drainage (I&D) of a parotid abscess?

Florida Subscriber

Answer: You should report the appropriate parotid code based on the difficulty of the excision. If the I&D is simple, for instance, and the surgeon performs the procedure at the patients bedside or in the office, you should report 42300* (Drainage of abscess; parotid, simple). But for a complicated procedure that requires a trip to the operating room, you instead should assign 42305 ( parotid, complicated).

Although the definitions for 42300 and 42305 do not state incision, the codes include the procedure. CPT lists both codes in the salivary gland and ducts subsection under the heading incision. Thus, despite the codes not stating incision and drainage of abscess, they include both procedures.

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