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Otolaryngology Coding Alert

Reader Questions:

42825 Sometimes Involves Suture

Published on Thu May 10, 2007

Question:  An otolaryngologist performs a tonsillectomy and a primary closure of a tonsillar fossae.  Should I bill for the closure or just the tonsillectomy?  The diagnoses are chronic tonsillitis and sleep apnea. Texas Subscriber Answer:  The otolaryngologist may opt to suture the tonsillar pillars after tonsillectomy or to leave them open for healing.  Include the closure in the tonsillectomy code, such as 42825 (Tonsillectomy, primary or secondary; younger than age 12) with both ICD-9 codes for the diagnoses that you indicate -- 474.00 (Chronic tonsillitis) and 327.23 (Obstructive sleep apnea) Closure has typically not been part of the procedure, but reports are finding that closing the tonsillar fossa is a useful procedure to reduce postoperative pain.
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