Wiki Excisional removal of nasopharyngeal mass

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sisadavis

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My surgeon removed a benign mass from the nasopharynx, method was by adenoid curette. The order was placed for adenoidectomy with nasopharynx bx, and submitted as a 42831, however the adenoids were not removed. Is this the correct CPT for the biopsy since he removed the entire mass? I do not think 42804-42806 are fitting here since the entire mass was indeed removed. Any suggestions would be appreciated. Thanks!
 
Cpt 42831 is for removal of the adenoids (in their entirety). So you cannot bill 42831 if the adenoids were not removed. Since this is a full excision of the mass (not just a biopsy sample), you would report CPT code 42808 for Excision (or destruction) of lesion of the pharynx (includes nasopharynx); any method.

For reference, my ENT Coder's Handbook states the following: "Do not report 42806 separately if nasopharyngeal biopsy is performed during the excision procedure (42808, Excision or destruction of lesion of pharynx, any method) on the same lesion. . . . procedure [42808] includes component procedure [42806] . . . ."

Hope that helps!
 
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