Pediatric Coding Alert

The Pediatric Coding Alert August 2010 "Reader Question: 40806 Represents Lingual Frenectomy" gave the incorrect code. "The correct code for a lingual frenotomy would be 41010 (Incision of lingual frenum [frenotomy]) not 40806 as the article states," explains Janet Kidneigh, CCS, CPC, otolaryngology, urology and cardiothoracic coding specialist at The Children's Hospital in Aurora, Colo. "40806 (Incision of labial frenum [frenotomy]) is the code for a labial frenotomy (lip tie)," Kidneigh says.

To keep the terms straight, know these key anatomical structures and procedures:

• labial -- associate with lip
• lingual (under the tongue) -- think linguistics (language - tongue).

Pay attention to whether the note describes a frenotomy or a frenectomy (40819, Excision of frenum, labial or buccal [frenumectomy, frenulectomy, frenectomy]). Frenotomies are performed to treat a congenital condition when newborns with tongue-tie cannot latch and suckle. Frenectomies are performed on patients who did not have frenotomies at birth.

"Tongue tie surgery (lingual frenectomy) involves more than just a simple clipping or a quick snip, but more involved tissue resection under general anesthetic," according to "Tongue-tie, Ankyloglossia or Short Fraenum" by Caroline Bowen, C. (2000). Retrieved from www.speech-language-therapy.com/tonguetie.html on (Nov. 9, 2010). Due to the involvement, a solid speech, dental or other reason must exist to justify the surgery.

Keep in mind that code 41010 is assigned 4.11 RVUs, whereas 40806 has 2.19 RVUs associated with it, meaning that miscoding either of these procedures could either cause your practice to collect nearly double what you're owed--or just half of what you should collect.