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Otolaryngology Coding Alert

READER QUESTIONS:

Fall Back on Unlisted Code for Pillar Implants

Published on Thu Feb 19, 2009

Question: My physician is considering placing "palatal struts" in a patient to treat a snoring problem. What CPT code would be appropriate for this procedure? California Subscriber Answer: Are you speaking of pillar implants? This is where an ENT uses a needle to insert three pieces of polyester mesh into the soft palate near where it meets the hard palate. Though research has shown the procedure helps reduce snoring in some patients, there is not yet a CPT code other than 42299 (Unlisted procedure, palate, uvula). If you use 42299, you might compare it to the new-for-2009 41512 (Tongue base suspension, permanent suture technique), which treats sleep apnea. Most physicians do this procedure for cash and charge the patient up front. You should create a homegrown "advance beneficiary notice" for pillar implants, and require patients to sign this informed consent. Do not send a claim to insurance; just collect cash [...]
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