AHA Coding Clinic® for HCPCS - 2019 Issue 4; Ask the Editor

Tonsillectomy with posterior pillar advancement flap

A patient with severely necrotic and infected tonsils bilaterally presented for a tonsillectomy. Under robotic vision, the tonsils were removed. As the tonsils extended deep into the fossa, it was decided to do a posterior pillar advancement backcut and flap to align the palate properly and alleviate some of the fossa depth bilaterally. What is the code for a tonsillectomy with a posterior pillar advancement flap? Is it appropriate to report CPT code 42227, Lengthening of palate, with island flap, to capture the flap? ...

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