42699

[jocoffey]

Hello,

Does anyone know what comparable code can be used for 42699? the procedure is removal of salivary stone with sialendoscope in the

right submandibular gland. Any help will be appreciated.

 

[JenniferB7]

The most comparable code (based on your description) would be CPT code 42330 for sialolithotomy; submandibular, uncomplicated, intraoral (a simple procedure). As usual, check payer guidelines. I know Aetna has a policy regarding sialendoscopy for salivary stone removal.

Hope that helps.

Sincerely,

Jennifer M. Connell, CPC, CPCO, CPC-P, CPB, CPMA, CPPM, CPC-I, CENTC

 

[k.vawter@yahoo.com]

Deciding factor is if incision was used or cannulation. 42330 is for incision. Reimbursement for 42699 is all over the place. Our doctors use cannulation a lot.

 

[Manders21]

Deciding factor is if incision was used or cannulation. 42330 is for incision. Reimbursement for 42699 is all over the place. Our doctors use cannulation a lot.

I was wondering what code you use for cannulation. I'm using this unlisted code and I can't find a comparable code to use but the doctor did use cannulation instead of incision.

 

[b.cobuzzi]

Depending on the documentation and the procedure. Some Sialendoscopy procedures are complex, but cause less trauma for the patient and the patient has quicker healing time. With those procedures, I equate to 42335, Sialolithotomy; submandibular (submaxillary), complicated, intraoral in box 19, but explain that the procedure was performed endsocopically and I list the patient benefits in box 19 of the claim.