Unlisted code 42299 is your only choice for LAUP.
Radiofrequency ablation (RFA) of the turbinates might be the procedure of choice for few physicians, however one on-going concern remains for a lot of ENT practices: “What CPT codes should I select for radiofrequency ablation techniques for turbinates, meant for the palate (UPPP), as well as for the tongue base?" Remember: Radiofrequency devices have two key purposes. Physicians might use them to ablate tissue or as actual cutting tools (e.g., for tonsillectomy). You must select CPT codes based on the exact way that your physician used the device.
1. Go For 41530 For RFA, Base Of Tongue
You could report 41530 (Submucosal ablation of the tongue base, radiofrequency, one or more sites, per session) in case your otolaryngologist treats OSA. This CPT® substituted 0088T (Submucosal radiofrequency tissue volume reduction of tongue base, one or more sites, per session [i.e., for treatment of obstructive sleep apnea syndrome]) in 2009. ICD-9 327.23 (Obstructive sleep apnea) along with at least one of the following listed secondary CPT codes (529.8, Other specified conditions of the tongue or 750.15, Macroglossia) are the only covered diagnoses for 41530. Ensure that these CPT codes are included in your claim, and should be documented in the medical record.
2. Laser-Assisted Uvulopalatoplasty Belongs To 42299 Alone
As far as RFA of the palate, uvula is concerned, you must use 42299 (Unlisted procedure, palate, uvula). CPT guidelines state that no other CPT® code fits suitably to define RFA of the palate or uvula, as well as debunk the option of using the uvulopalatopharyngoplasty code 42145 (Palatopharyngoplasty [e.g., uvulopalatopharyngoplasty, uvulopharyngoplasty]) appended by modifier 52 (Reduced services). You cannot go ahead and use 42145 (or 42145-52) as this code signifies an excisional removal of the uvula and palate, as well as the laser ablation (or reduction in size) does not meet the rules for an excisional removal as needed for 42145. Moreover, CMS has specified that they do not think through a LAUP or a RFA of the uvula or palate standards of care and take them experimental.
3. RFA Of Inferior Turbinates: 30801 For Surface Layer; 30802 For Intramural Soft Tissue
You should deliberate over the exact nature of the procedure while coding RFA of the inferior turbinates. For example, 30802 (Ablation, soft tissue of inferior turbinates, unilateral or bilateral, any method [e.g., electrocautery, radiofrequency ablation, or tissue volume reduction]; intramural [i.e., submucosal]) defines the ablation or cauterization of the deeper mucosal soft tissue, whereas 30801 (… superficial) relates to the ablation or cauterization including only the surface layer of the mucosa.
Radiofrequency ablation (RFA) of the turbinates might be the procedure of choice for few physicians, however one on-going concern remains for a lot of ENT practices: “What CPT codes should I select for radiofrequency ablation techniques for turbinates, meant for the palate (UPPP), as well as for the tongue base?" Remember: Radiofrequency devices have two key purposes. Physicians might use them to ablate tissue or as actual cutting tools (e.g., for tonsillectomy). You must select CPT codes based on the exact way that your physician used the device.
1. Go For 41530 For RFA, Base Of Tongue
You could report 41530 (Submucosal ablation of the tongue base, radiofrequency, one or more sites, per session) in case your otolaryngologist treats OSA. This CPT® substituted 0088T (Submucosal radiofrequency tissue volume reduction of tongue base, one or more sites, per session [i.e., for treatment of obstructive sleep apnea syndrome]) in 2009. ICD-9 327.23 (Obstructive sleep apnea) along with at least one of the following listed secondary CPT codes (529.8, Other specified conditions of the tongue or 750.15, Macroglossia) are the only covered diagnoses for 41530. Ensure that these CPT codes are included in your claim, and should be documented in the medical record.
2. Laser-Assisted Uvulopalatoplasty Belongs To 42299 Alone
As far as RFA of the palate, uvula is concerned, you must use 42299 (Unlisted procedure, palate, uvula). CPT guidelines state that no other CPT® code fits suitably to define RFA of the palate or uvula, as well as debunk the option of using the uvulopalatopharyngoplasty code 42145 (Palatopharyngoplasty [e.g., uvulopalatopharyngoplasty, uvulopharyngoplasty]) appended by modifier 52 (Reduced services). You cannot go ahead and use 42145 (or 42145-52) as this code signifies an excisional removal of the uvula and palate, as well as the laser ablation (or reduction in size) does not meet the rules for an excisional removal as needed for 42145. Moreover, CMS has specified that they do not think through a LAUP or a RFA of the uvula or palate standards of care and take them experimental.
3. RFA Of Inferior Turbinates: 30801 For Surface Layer; 30802 For Intramural Soft Tissue
You should deliberate over the exact nature of the procedure while coding RFA of the inferior turbinates. For example, 30802 (Ablation, soft tissue of inferior turbinates, unilateral or bilateral, any method [e.g., electrocautery, radiofrequency ablation, or tissue volume reduction]; intramural [i.e., submucosal]) defines the ablation or cauterization of the deeper mucosal soft tissue, whereas 30801 (… superficial) relates to the ablation or cauterization including only the surface layer of the mucosa.
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