Radiology Coding Alert

Question: In a patient with pain and swelling in the area of the parotid gland, our physician did an X-ray examination to confirm sialoadenitis. Then he did a contrast examination of the gland. How can we report these services?

Virginia Subscriber

Answer: For the X-ray examination of the salivary gland, submit the CPT^® code 70380 (Radiologic examination, salivary gland for calculus). Your physician will look for evidence of a calculous in the salivary gland in the X-ray examination.

X-rays are often not conclusive for evidence of stones in the gland, so your physician seems to have decided to do a sialography. In this procedure, your physician will inject contrast into the duct of the salivary gland and obtain imaging. For sialography, submit code 70390 (Sialography, radiological supervision and interpretation). You can append modifier 26 (Professional component) if you are reporting only the physician’s services for interpretation and report.

Stones or calculi in the salivary glands cause inflammation, pain, and enlargement of the gland. The diagnosis of sialoadenitis applies to a large inflamed and painful salivary gland. Check for more details for the recurrence and acute or chronic course of the inflammation. You can identify an acute onset of inflammation by the sudden onset where as a chronic course will have a long sustained history of pain and swelling. A chronic course may be characterised by several recurrences. Accordingly, you select from the ICD-10-CM codes K11.21 (Acute sialoadenitis), K11.22 (Acute recurrent sialoadenitis), and K11.23 (Chronic sialoadenitis). Your physician seems to have not specified any of these details. If this is the case, you can submit the ICD-10-CM code K11.20 (Sialoadenitis, unspecified).