Otolaryngology Coding Alert

Question: A patient was treated for hypernasality that the otolaryngologist found was caused by a tumor in the nasopharynx impinging on velum. The ENT calls it an organic lesion. How should I code the cause?

Florida Subscriber

Answer: You would code the medical cause (a tumor in the nasopharynx) as 239.0 (Neoplasms of unspecified nature; digestive system). For a tumor without histologic confirmation, you use the unspecified code based on site. Code 239.0 includes all unspecified nasopharyngeal neoplasm locations (meaning contiguous sites, floor, roof, specified site NEC, and wall). The velum is the soft palate.

Error averted: Make sure to first code the condition being treated. So you would code hypernasality (784.43) followed by neoplasm of digestive system (239.0). "Organic lesions in the hypopharynx or nasopharynx could cause either hypernasality or hyponasality, depending on the location and extent of the lesion," says Nancy Swigert, MA, CCC-SLP, BRS-S, who is a speechlanguage pathologist (SLP) and a board-recognized specialist in swallowing and swallowing disorders.