42699

jocoffey

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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

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Local Chapter Officer
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Victoria, TX
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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
 
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Topeka, KS
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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

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Auburn Hills, MI
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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

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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.
 
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