Wiki Tongue-tie release

[misty1908]

I have a question regarding the billing of a tongue-tie release procedure. There seems to be some question between using CPT 40819 and CPT 41115. The problem is that the doctor refers to the procedure as a frenulectomy and feels that 40819 is correct. I disagree because 40819 is for the labial or buccal frenum and the procedure we are doing is for the lingual frenum. Does anyone else have any experience with these codes?

 

[Lisa Bledsoe]

41010

Is he/she actually performing an excision of the frenum or just cutting it? We use 41010.

 

[FTessaBartels]

Not 40819

You are correct that 40819 is NOT appropriate, as this code is for the labial or buccal frenum.

If doctor is simply incising frenum to allow greater range of motion of tongue, then use 41010. If doctor is excising the entire frenum, then use 41115.

F Tessa Bartels, CPC, CEMC

 

[glgallup08]

wouldn't 41115 be a better code
41115 -removes a tight or short lingual frenum to free the tongue and allow greater range of motion. The lingual frenum is the connecting fold or membrane under the tongue that attaches it to the floor of the mouth. The physician makes incisions in the frenum both near the tongue and near the mandible, which ultimately connect as they move posteriorly. The frenum is excised. The surgical wound may be sutured.

40819 - removal of the labial or buccal frenum. The buccal frenum is a band of mucosal membrane that connects the alveolar (dental) ridge to the cheek and separates the lip vestibule from the cheek vestibule. The labial frenum is a connecting fold of mucous membrane that joins the lip to the gums at the inside midcenter. Incisions are made around the frenum and through the mucosa and submucosa. The underlying muscle is removed as well. The excision may extend to the interincisal papilla. The mucosa is closed simply, or the physician may rearrange the tissue as in a Z-plasty technique.

41010 Incision of lingual frenum (frenotomy) Consumer Friendly Full Consumer Friendly Short Spanish

Lay Description (Code): ​ The physician makes an incision in the lingual frenum, freeing the tongue and allowing greater range of motion. The lingual frenum is the connecting fold or membrane under the tongue that attaches it to the floor of the mouth. Sutures may be placed. The frenum is simply incised and not removed.

Tips ​ Coding Tip Suturing is not reported separately. Local anesthesia is included in the service. For frenoplasty, see 41520. For lingual frenectomy, see 41115. Surgical trays, A4550, are not separately reimbursed by Medicare; however, other third-party payers may cover them. Check with the specific payer to determine coverage. Suturing is not reported separately. Local anesthesia is included in this service. For frenoplasty, see 41520. For lingual frenectomy, see 41115. This procedure is often included in a more comprehensive service when performed during the same encounter and may not be billed separately. Check with third-party payers for their specific guidelines. Documentation Tip The infectious agent, if known, should be documented in the medical record.

 

[freespririt0806]

41010 if he is just cutting it to allow better range of movement