tci General Surgery Coding Alert - 2006 Issue 5

Reader Questions: Treat All Adenoidectomies With Tonsillectomy the Same

Question: When reporting adenoidectomy with tonsillectomy, does it matter if the adenoidectomy is primary or secondary?Massachusetts Subscriber Answer: For adenoidectomy only (that is, adenoidectomy without tonsillectomy), you must determine from the surgeon's documentation whether he performed a primary or secondary adenoidectomy. For primary adenoidectomy, you should report 42830 (Adenoidectomy, primary; under age 12) or 42831 (... age 12 or over), as appropriate for the patient's age. Similarly, for secondary adenoidectomy, you should report 42835 (Adenoidectomy, secondary; under age 12) or 42836 (... age 12 or over). Consider that you may have to look to previous documentation to determine...

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