tci Part B Insider - 2012 Issue 41

Part B Coding Coach: 3 Steps Steer Your Tonsil/Adenoid Removal Claims Toward Success

Secret: You can use 42820, 42821 as universal T&A codes.Warning: You must know a patient's age and prior surgery status before you code tonsillectomy and adenoidectomy claims. Otherwise, you could be choosing the wrong code or even unbundling procedures.Step 1: Check the Patient's AgeWhen coding for tonsillectomies and/or adenoidectomies, you should choose the appropriate code based on the patient's age.CPT® contains two tonsillectomy codes, four adenoidectomy codes, and two combination codes - all of which separate at age 12. For a child who is under the age of 12, you will use:42820 -- Tonsillectomy and...

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