Otolaryngology Coding Alert
'Unlisted' 42299 or 69799 Are Best Choice for Rerouting Palatal Muscle
Question: Our ENT wants to offer a new procedure for the treatment of patulous Eustachian tube dysfunction. It is like a Eustacian tuboplasty except he goes through the palate. We believe it is called rerouting of the palatal muscle with or without pterygoid hamulotomy. What CPT® code would we use for that?
Arizona Subscriber
Answer: Unfortunately, CPT® does not include a code for any of the tests to check for Eustacian tube patency or function, or treatment of a diagnosed problem. Some otolaryngologists assign 92567 (Tympanometry [impedance testing]), but 92567 only allows payment for the pressure reading and not the additional tests.
A better choice is unlisted procedure code 42299 (Unlisted procedure, palate, uvula) or 69799 (Unlisted procedure, middle ear). Submit the claim on paper and attach an explanation of the study or procedure performed. This way, you are coding to the highest specificity and allowing the AMA to collect data on unlisted procedures, which could potentially lead to a specific CPT® code in the future.
Otolaryngology Coding Alert
- CCI 20.0:
Don't Jump to Report New Consultative Services Codes, Thanks to Bundling Edits
Tip: Assume modifier indicator ‘0’ applies. The latest rendition of Correct Coding Initiative (CCI) edits [...] - Quality Reporting:
Prepare to Implement 4 New PQRS Measures for Otolaryngology in 2014
Also watch for opportunities to report the measure’s group for sleep apnea. CMS finalized 285 [...] - Compliance:
Let 3 Tips Start Your Year With Better Provider Documentation
Hint: Legibility and timing are still top concerns. Coding accuracy might be your top priority [...] - ICD-10:
Encourage Physicians to Document 'Recurrent' for Future Acute Sinusitis Diagnoses
General descriptors for 461 code family make a straightforward shift. With a new focus on [...] - You Be the Coder:
Reporting Ear Tube Insertion Under MAC
Question: Our physician removed a patient’s ear tubes in an ASC setting under MAC anesthesia [...] - Reader Question:
Appeal Payer's Decision to Bundle 30560 With 30130
Question: One of our private payers has started bundling 30560 with 30130. I haven’t found these codes [...] - Reader Question:
'Unlisted' 42299 or 69799 Are Best Choice for Rerouting Palatal Muscle
Question: Our ENT wants to offer a new procedure for the treatment of patulous Eustachian [...] - Reader Question:
Claim With 12051 and 11442 Should Be Allowed
Question: Humana denied our claim listing 12051 with 11442. We’re not sure what the problem [...] - Reader Question:
Remember Modifier 59 for 60252/60240 Claim
Question: The surgeon performed a left thyroidectomy for malignancy, with a neck dissection and a [...]
