Alyssaw80107
New
The physician is listing this procedure as 1. Tonsillectomy 2. Uvulopalatopharyngoplasty 3. Bilateral Adjacent Tissue Transfer (Palatopharyngeus Muscle Flaps)- Functional Expansion Pharyngoplsaty Technique
(To treat obstructive sleep apnea)
He wants me to code this as 42145 (UPPP), 14040 (adjacent tissue transfer or rearrangement mouth), and 42826
OP NOTE (after routine tonsillectomy): After approprate time for medication to take effect, i turned attention the right tonsillar pillar. The palatopharyngeus muscle was carefully sepated off the superior constrictor muscle at the bottom third of its course and an anchor stitch was secured around the muscle belly using a stick-tie technique. Careful electrocautery was then used to divide this muscle untill about 1cm x 0.5cm muscle flap was elevated. A suture was then placed through the fascial sling of the hamulus, and passed into the superior tonsillar fossa. This was placed though the muscle flap and then passed back superiorly again through the fascial sling of the hamulus. After creathing a tunnel with right angle dissector, the muscle and mucosa and roated up and the sutre was tied down to hold this in place. A second 3-0 vicryl suture was then used to secure the flap within the tunnel at the midpoint of the tunnel. This created substantial increase in the retropalatal space and depth. This procedure was then carried out identically on the left side. The uvula was noted to be significantly elongated and a 15 blade was used to shorten the uvula to more appropriate lenth. Sutures were then used to close the uvular muscle and mucosa. Additional sutures were then used to re-approximate the muscle and mucosal layers of the tonsillar fossae.
I feel like this is 42950 (Pharyngoplasty) with 42826 (tonsillectomy) or something else. But another physician who does this procedure for OSA told my physician how to code this. Just trying to confirm!
(To treat obstructive sleep apnea)
He wants me to code this as 42145 (UPPP), 14040 (adjacent tissue transfer or rearrangement mouth), and 42826
OP NOTE (after routine tonsillectomy): After approprate time for medication to take effect, i turned attention the right tonsillar pillar. The palatopharyngeus muscle was carefully sepated off the superior constrictor muscle at the bottom third of its course and an anchor stitch was secured around the muscle belly using a stick-tie technique. Careful electrocautery was then used to divide this muscle untill about 1cm x 0.5cm muscle flap was elevated. A suture was then placed through the fascial sling of the hamulus, and passed into the superior tonsillar fossa. This was placed though the muscle flap and then passed back superiorly again through the fascial sling of the hamulus. After creathing a tunnel with right angle dissector, the muscle and mucosa and roated up and the sutre was tied down to hold this in place. A second 3-0 vicryl suture was then used to secure the flap within the tunnel at the midpoint of the tunnel. This created substantial increase in the retropalatal space and depth. This procedure was then carried out identically on the left side. The uvula was noted to be significantly elongated and a 15 blade was used to shorten the uvula to more appropriate lenth. Sutures were then used to close the uvular muscle and mucosa. Additional sutures were then used to re-approximate the muscle and mucosal layers of the tonsillar fossae.
I feel like this is 42950 (Pharyngoplasty) with 42826 (tonsillectomy) or something else. But another physician who does this procedure for OSA told my physician how to code this. Just trying to confirm!