Otolaryngology Coding Alert

Question: My physician noted that he performed “Right radical submandibular gland removal with lymph nodes, supraomohyoid.” How should I bill this? 

West Virginia Subscriber

Answer: Your best choice probably is 38700 (Suprahyoid lymphadenectomy). Code 42440 (Excision of submandibular [submaxillary] gland) is bundled into 38700 so you would not code or bill for that separately unless it was performed on the contralateral side. If that was the case, you would append modifier 59 (Distinct procedural service) or modifier XS (Separate structure) for Medicare to indicate the separate site.