Tonsillectomy W/Revision Adenoidectomy

ieshiarenee

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We have a patient (age 3) who had a primary tonsillectomy and a revision adenoidectomy. How would you code this?
Normally, a T & A would be coded 42820/42821 depending on the age of the patient, but the revision adenoid is throwing me off.
I tried coding 42825, 42836, but that is incorrect. Any thoughts?
 

cpc2007

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I would report the combined tonsillectomy/adenoidectomy codes (42820/42821) even if the adenoidectomy is secondary since the code descriptor for these codes does not differentiate primary vs. secondary for the tonsillectomy or the adenoidectomy. I was able to locate a supercoder.com coding alert that is open source online and supported this guidance: https://www.supercoder.com/coding-n...es-secondary-matter-for-adenoidectomy-article. Also the presence of the NCCI edit prohibiting reporting the primary tonsillectomy code with a secondary adenoidectomy code would lead us back to reporting this combined code as well.

I hope that helps :).
 
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