Otolaryngology Coding Alert

Question: An otolaryngologist plans on treating precancerous multiple mucosal lip lesions with a laser. Should I use 40810 x 2 for Medicaid?Utah SubscriberAnswer:No, laser lesion destruction in the mouth's vestibule falls under 40820 (Destruction of lesion or scar of vestibule of mouth by physical methods [e.g., laser, thermal, cryo, chemical]). If the physician had instead excised a mucosal or submucosal lip- or cheek-tissue lesion without repair, you would use the code you mention, 40810 (Excision of lesion of mucosa and submucosa, vestibule of mouth; without repair).Warning: Code only completely distinct additional lesions your surgeon destroyed. If the lesions share borders or are adjacent, do not code separate destructions.Wait to file the claim until you have the pathology report. The diagnoses may help you to substantiate coding an additional 40820. For instance, if the lip lesions come back as cancerous, and documentation shows they are on the upper and lower lip, [...]