Otolaryngology Coding Alert

Question: The surgeon resected the patient’s right styloid process. What code do we file for a styloidectomy?

New Jersey Subscriber

Answer: CPT^® 2016 does not include a code specific to styloidectomy. Based on information from the AOA-HNS, you should file the claim with 21499 (Unlisted musculoskeletal procedure, head) and supporting documentation.

Explanation: Styloidectomy is normally the treatment of choice for Eagle’s syndrome, a condition that involves elongation of the styloid process or calcification of the stylohyloid ligament. Code the diagnosis based on the patient’s symptoms. These can include sharp, shooting pains in the jaw, back of the throat, ears, neck, and/or face; difficulty swallowing; and the sensation of having something caught in the throat. Diagnoses that are often linked with a styloidectomy include:

• G50.0          Trigeminal neuralgia
• G50.1          Atypical facial pain
• M54.2          Cervicalgia
• R07.0          Pain in throat
• R13.10        Dysphagia, Unspecified
• R13.19        Other Dysphagia (Cervical Dysphagia)

Ask your doctor to give you a similar CPT^® code with which you can compare this unlisted code so that you can value it and give a benchmark to the third party payer to assist them in valuing the service.