Advanced Search

Otolaryngology Coding Alert

Reader Questions:

Check for Scope With Tonsil Biopsy

Published on Wed Mar 16, 2005

Question: How should I report a punch excisional biopsy of the left tonsil?


Tennessee Subscriber
 

Answer: No specific code exists for a biopsy of the tonsils.

You should instead report the code based on whether the otolaryngologist used a scope. If he didn't, you should assign 42800 (Biopsy; oropharynx).

If the physician used an endoscope, you should report  31535 (Laryngoscopy, direct, operative, with biopsy) or 31536 (... with operating microscope). 

Note: CPT classifies "indirect" laryngoscopy as an endoscopy, even though the procedure requires a mirror, not an endoscope.
You’ve reached your limit of free articles. Already a subscriber? Log in.
Not a subscriber? Subscribe today to continue reading this article. Plus, you’ll get:
  • Simple explanations of current healthcare regulations and payer programs
  • Real-world reporting scenarios solved by our expert coders
  • Industry news, such as MAC and RAC activities, the OIG Work Plan, and CERT reports
  • Instant access to every article ever published in your eNewsletter
  • 6 annual AAPC-approved CEUs*
  • The latest updates for CPT®, ICD-10-CM, HCPCS Level II, NCCI edits, modifiers, compliance, technology, practice management, and more
*CEUs available with select eNewsletters.

Other Articles in this issue of

Otolaryngology Coding Alert

View All