Otolaryngology Coding Alert

Question: How should I code for a partial uvulectomy? The surgeon documents an excision of 50 percent of the uvula.

Texas Subscriber

Answer: The only code available for a uvulectomy is 42140 (Uvulectomy, excision of uvula). However, the work included in this code involves the excision of the entire uvula. In the instance that the surgeon only partially excises the uvula, you should code 42140 with modifier 52 (Reduced Services) appended. The claim should be sent on paper in addition to electronically (for timely filing). Indicate that the physician removed 50 percent of the uvula in Box 19 of the claim so that the payer knows how to process modifier 52 and price the service. On the paper submission, you should include the operative report and a detailed explanation justifying the use of modifier 52.