Otolaryngology Coding Alert

Question: What CPT code should I report for an endoscopic cricopharyngeal myotomy using the Weerda Zenker diverticuloscope?

Georgia Subscriber

Answer: Because the otolaryngologist in your example uses an endoscopic, rather than a cervical approach, you should use unlisted procedure code 43499 (Unlisted procedure, esophagus).

At first glance, you may assume the correct code is 43130 (Diverticulectomy of hypopharynx or esophagus, with or without myotomy; cervical approach). Code 43130, however, describes an open surgery.

Good idea: Write a letter to the CPT AMA Committee (address in front of CPT book) and the Practice Management Board of the Academy of Otolaryngology- Head and Neck Surgery (AAO-HNS). Explain to the members that the otolaryngologist is performing cricopharyngeal myotomy endoscopically.

You should take this extra step every time that a surgeon performs a CPT defined open surgery endoscopically. Alerting the proper agencies that surgeons are now performing the open surgery endoscopically helps the boards eventually obtain CPT codes to describe the endoscopic surgery.

Remember: You should use the unlisted code in this situation, so that new relative value units (RVUs) can be assigned to this procedure once CPT advisers assigning a CPT code to this procedure.