Wiki ent coder

[jocoffey]

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 billed together. Should we bill the combined code 42821 which is removal of tonsils and adenoids?

Does anyone know why those 2 codes cannot be billed together? Thank You

 

[nickelclaw]

Use the combo cpt

You may not use both because that would be unbundling. Which is why CPT has an adenoid-tonsillectomy code 42820 or 42821 by age.
If only one side of adenoid is removed with both tonsil then use mod 52.

Thanks,