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Otolaryngology Coding Alert

READER QUESTIONS:

Code Depends on Whether ENT Used Scope

Published on Thu Feb 19, 2009

Question: My physician used a laryngoscope to treat a patient who has cerebral palsy spasms and difficulty swallowing. How do I code a "cricopharyngeal muscle Botox injection?" West Virginia Subscriber Answer: Since your ENT injected the Botox with a laryngoscope, use 43201 (Esophagoscopy, rigid or flexible; with directed submucosal injection[s], any substance). Gastroenterologists use this code more often than ENTs, but it accurately describes the procedure. Otolaryngologists usually inject Botox through the skin. If your ENT injected the patient percutaneously, use 64613 (Chemodenervation of muscle[s]; neck muscle[s] [e.g., for spasmodic torticollis, spasmodic dysphonia]). If your ENT used an electromyogram (EMG) to guide the percutaneous injection, the following codes are available: +95873 (Electrical stimulation for guidance in conjunction with chemodenervation [List separately in addition to code for primary procedure]) and +95874 (Needle electromyography for guidance in conjunction with chemodenervation [List separately in addition to code for primary procedure]). Append modifier 26 [...]
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