Otolaryngology Coding Alert
The Best Code for Lysis of Tonsil Adhesion
Question: A tonsillectomy patient now has a piece of skin adhered to the uvula. The doctor wants to do a lysis of tonsil adhesion, but I’m not sure what code to use. What do you recommend?
Michigan Subscriber
Answer: It is difficult to make a firm recommendation based on such limited information, but it seems that 42104 (Excision, lesion of palate, uvula; without closure) might be the most appropriate code. During the procedure described by 42104, the surgeon removes a lesion from the palate or uvula but does not perform any closure at the site. If this description does not fit what your physician documented, get more information before choosing a code and submitting the claim.
If you are in the global period of the tonsillectomy, make sure to include a 79 modifier (Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period) with 42104 to indicate that the surgery is unrelated to the original reason for performing the tonsillectomy.
Related Articles
Otolaryngology Coding Alert
- ICD-10:
October Will Bring Your First Official Updates to ICD-10
Look for expanded options for hearing loss, tinnitus, and more. Just as you’ve been getting [...] - New Code Check-In:
Be Sure You Know How to Handle Drug-Eluting Stent Coding
Start with a solid understanding of when they’re necessary. CPT® 2016 introduced two new [...] - Reader Question:
Code 92550 Covers Both Ipsilateral and Contralateral Reflexes
Question: Does code 92550 only apply when ipsilateral and contralateral reflexes are performed? If the equipment [...] - Reader Question:
Work of 60240 Includes Work of 60500
Question: Can someone help me explain to my physician why CPT® code 60500 bundles into 60240? [...] - Reader Question:
Learn the Ins and Outs of App Privacy
Question: Our clinicians are using more and more apps for a variety of reasons, including clinical [...] - Reader Question:
Verify Approach Before Assigning Submandibular Drainage Code
Question: Our surgeon recently performed drainage of an abscess in the submandibular space (the abscess had [...] - Reader Question:
Submit 'Unlisted' 92700 for VEMP
Question: I am trying figure out the best CPT® codes to use for a Dix-Hallpike test [...] - Reader Question:
The Work of 30905 Includes 30901
Question: My doctor states that he did both anterior and posterior packing for epistaxis on the [...] - Reader Question:
Keep Up With What OIG Is Watching
Question: I know that different reports come out periodically to show the issues or procedures that [...] - Reader Question:
Let Work, Not Follow-Up Designation, Guide E/M Code Choice
Question: Our physician recently saw a patient because of an abscess on her neck. He [...] - You Be the Coder:
The Best Code for Lysis of Tonsil Adhesion
Question: A tonsillectomy patient now has a piece of skin adhered to the uvula. The doctor [...]
