Otolaryngology Coding Alert

Question: Our physician obtained a biopsy from the anterior pillar and also removed the upper half of the tonsil. Would this still be considered 42842?

New Jersey Subscriber

Answer: You are correct, 42842 (Radical resection of tonsil, tonsillar pillars, and/or retromolar trigone; without closure) is the appropriate choice. During this procedure, the physician removes the tonsils, tonsillar pillars and/or the retromolar trigone (the small area behind the wisdom teeth), often as a way to remove cancerous growths. If necessary, he also removes portions of the maxilla or mandible that are affected. The resulting wound is so large that it is left open to be grafted during a later procedure.