Outpatient Facility Coding Alert
Reader Question:
Consider Patient History Before Reporting 42225
Published on Fri Feb 14, 2020 
PDF
PDF
Question: How should I code an operative note note that involves the surgeon performing a partial flap takedown as part of a revision of a pharyngeal flap procedure performed two years prior? Montana Subscriber Answer: The physician may only perform a palatoplasty with attachment of a pharyngeal flap once; therefore, code 42225 (Palatoplasty for cleft palate; attachment pharyngeal flap) is out of the question. Furthermore, the October 2019 issue of CPT® Assistant covers this topic, in which it recommends that you should instead report 42950 (Pharyngoplasty (plastic or reconstructive operation on pharynx)) for the revision “because the flap was created in a previous procedure.”
Related Articles
Other Articles in this issue of
Outpatient Facility Coding Alert
- ICD-10-CM Coding:
Try Out These 2 Demanding ICD-10-CM Surgical Setting Scenarios
Use all guidelines at your disposal for post-surgical complications Getting to the bottom of a [...] - Modifiers:
Learn The Ropes of Modifier 53 Coding for Terminated Biopsies
Consider a number of variables, including use of CT guidance. Biopsy coding can become a [...] - CPT® Coding:
Get Answers to 4 Pertinent Skin Biopsy Questions
Use these FAQs as a reference for your future skin biopsy claims. Any general surgery [...] - You Be the Coder:
Factor Pressure Ulcer Stage Into Coding Determination
Question: I am looking for the code(s) to report for the debridement of an infected [...] - Reader Question:
Know How MUEs Can Affect Bilateral Billing
Question: Why might I be receiving a denial for frequency when submitting two units of [...] - Reader Question:
Consider Patient History Before Reporting 42225
Question: How should I code an operative note note that involves the surgeon performing a [...] - Reader Question:
Stay-Tuned for New Vaping Disorder Code
Question: I’ve heard there’s a new diagnosis code coming out for patients with vaping-related conditions. [...]
View All