Otolaryngology Coding Alert

Reader Questions:

Stop Snoring With Payment

Question: My otolaryngologists are starting to offer injection snoreplasty. How should I report this procedure?

Tennessee Subscriber

Answer: Because CPT does not contain a code for the procedure, you should use unlisted-procedure code 42999 (Unlisted procedure, pharynx, adenoids, or tonsils), unless a third-party payer recommends another code.

Insurance companies consider the injection procedure to control snoring cosmetic and therefore a noncovered service. For instance, Aetna states, "Treatment of snoring alone is not considered medically necessary and is not covered." Make sure to charge patients cash up-front at the time of the first treatment.
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