Wiki cpt code 40806 "incision of labial frenum"

[hallansmom]

I work for a Pediatric ENT group in Florida and am in need of assistance with cpt code 40806. Florida Medicaid is stating that it is a non-payable procedure. In the office we perform an upper lip frenotomy " The upper lip was retracted using a sponge.The frenulum was thus retracted and divided using Iris scissors. Minimal bleeding was encountered that was cauterized using a small amount of silver nitrate. The patient tolerated the procedure well." Please let me know what other code is used when performing a simple procedure.

 

[hallansmom]

Can anyone please assist me with this?

 

[nsteinhauser]

40806 is an 'office procedure' so it should be payable in an office but maybe it's not on the Florida Medicaid list of allowable cpt codes? If you can't separately charge for the procedure, you would charge an office visit. Hope this helps.

 

[hallansmom]

Thank you .......do you know of a comparable code to 40806?

 

[nsteinhauser]

That's the only code for that procedure. Can you bill an E/M code for the office visit?