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AHA Coding Clinic® for HCPCS - 2013 Issue 3; Ask the Editor

Excision lesion, right piriform sinus

A patient has a papillomatous lesion on the right piriform sinus and excision is recommended. A bronchoscope was placed to keep an open airway. With the bronchoscope in place, the laryngoscope was brought in and the larynx re-examined. A lesion was noted on the right piriform sinus. The lesion was excised from the pedicle utilizing the cup forceps. After bleeding at the pedicle was controlled, the microlaryngoscope along with the CO2 laser was utilized to vaporize the pedicle of the lesion. This concluded the procedure. Our coders are not sure whether to use CPT code 31541, Laryngoscopy, direct, operative, with excision of tumor and/or stripping of vocal cords or epiglottis, with operating microscope or telescope, or 42808, Excision or destruction of lesion of pharynx, any method, since the piriform fossa is considered part of the hypopharynx. What is the correct CPT code for the excision of the lesion via the microlaryngoscopy with CO2 laser?  ...

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