CPT^® 42870, Under Excision and Destruction Procedures on the Pharynx, Adenoids, and Tonsils

The Current Procedural Terminology (CPT^®) code 42870 as maintained by American Medical Association, is a medical procedural code under the range - Excision and Destruction Procedures on the Pharynx, Adenoids, and Tonsils.

Additional/Related Information

Tabs

Summary

During this procedure, the provider removes or destroys the lingual tonsils located on the dorsal surface of the base of the tongue. When enlarged, the tonsils can restrict the airway passage.

For clinical responsibility, terminology, tips and additional info
start codify free trial.

View any code changes for 2024 as well as historical information on code creation and revision.

Crosswalks

Tabs

Combat the #1 denial reason - mismatched CPT-ICD-9 codes - with top Medicare carrier and private payer accepted diagnoses for the chosen CPT® code.

View the CPT® code's corresponding procedural code and DRG. In a click, check the DRG's IPPS allowable, length of stay, and more. To plug inpatient facility revenue drains, subscribe to DRG Coder today.

Crosswalk to an anesthesia code and its base units, and calculate payments in a snap! Subscribe to Anesthesia Coder today.

View matching HCPCS Level II codes and their definitions.

Forum

Have a question about CPT Code 42870 ? Start a discussion here

Modifier 55

Is modifier 55 used only when a provider outside of the group used? Example: Dr. P from head/neck performs tonsillectomy on 04/04/22. Pt has post op bleeding at the site. Dr. B from same dept/group pe... [ Read More ]

Excision of oral cavity lesions in: submucosal nodules in oral commissure buccal and tongue/tonsil base

[LIST] [*]31536 - direct laryngoscopy and biopsy [*]11400-11471 Excision-Benign Lesions Procedures on the Skin - for excision of lesions in oral commissure [*]40819 - buccal [I](hard to determine with... [ Read More ]

Cpt code for epiglottopexy? 31561 42870 arytenoidectomy epiglottopexy laryngoscopy lingual tonsillectomy supraglottoplasty

I have been doing so much research on a code for epiglottopexy but I'm not having much success. I read that an epiglottopexy is done in a supraglottoplasty procedure. I usually use cpt code 31561 for ... [ Read More ]

Lingual tonsillectomy with epiglottopexy 31561 42870 epiglottopexy lingual tonsillectomy supraglottoplasty

Is an epiglottopexy inclusive to a lingual tonsillectomy? I don't see NCCI edits but since it's in the same area, I just wanted to check. Also, from my understanding an epiglottopexy is part of the su... [ Read More ]

Lingual tonsillectomy with epiglottopexy 31561 42870 epiglottopexy lingual tonsillectomy suppraglottoplasty

ent coder

Our physician is trying to bill cpt code 42870(lingual tonsils removal) with cpt code 42831-(adenoidectomy), however our code correct system, says these 2 codes are not permitted to be b... [ Read More ]

CPT Code 42870

The lay description from EncoderPro for CPT 42870 reads: The physician removes or destroys the [U][B]lingual tonsils[/B][/U]. Because the abscessed tonsils may restrict the airway passage, the physici... [ Read More ]

CPT Code 42870

I just have a question regarding 42870....if both tonsils were removed do I use modifier 50 or does this code include both tonsils? Just a little confused with the description.... [ Read More ]

View All