Otolaryngology Coding Alert
Does 42825 Involve Sutures?
Question: Our otolaryngologist performed 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. You should include the closure in the tonsillectomy code, such as 42825 (Tonsillectomy, primary or secondary; younger than age 12) with both ICD-10 codes for the diagnoses that you indicate: J35.01 (Chronic tonsillitis) and G47.33 (Obstructive sleep apnea (adult) (pediatric)). Closure has typically not been part of the procedure, but some surgeons believe that closing the tonsillar fossa is a useful procedure for reducing postoperative pain.
Related Articles
Otolaryngology Coding Alert
- ICD-10-CM Coding:
Check New Codes for COVID-19, Cough With Hemorrhage, and More
Plus: You’ll find expanded coding options for dysphagia, immunization counseling, and more. Looking for new [...] - Part B Payments:
Otolaryngologists Could See Cuts Under Proposed Fee Schedule
But telehealth pay could continue into 2023, if the proposal is finalized. Otolaryngologists could see [...] - E/M Coding:
6 Ways to Shore up Your Inpatient E/M Codes
Remember: Subsequent inpatient care is reported on a per-day basis. When your otolaryngologist performs rounds [...] - You Be the Coder:
Does 42825 Involve Sutures?
Question: Our otolaryngologist performed a tonsillectomy and a primary closure of a tonsillar fossae. Should [...] - Reader Questions:
Ask for All Insurance Cards at Every Visit
Question: Thanks for your article last month about appeals. One of the points was to [...] - Reader Questions:
Ask Providers for More Info, But Don’t Ask Leading Questions
Question: One of our newer otolaryngologists often creates documentation that’s missing the details we need to [...]
