Don't have a TCI SuperCoder account yet? Become a Member >>

Outpatient Facility Coding Alert

Reader's Question:

Report 42227 for Lengthening of Palate

Question: The provider often gives us unlisted codes which makes it difficult to get paid.  Following is an example:

He performed a “Revision of palatal island rotation flap.” It needed to be debrided and the formation of granulation tissue started. He used 42299 paired with a diagnosis of 145.9. Can you suggest any other codes that are not “unlisted”? 

Kansas Subscriber

Answer: If lengthening of the palate is being done with island flap, then 42227 (Lengthening of palate, with island flap) can be used. Otherwise for “Revision of palatal island rotation flap” 42299 (Unlisted procedure, palate, uvula) is the appropriate code. His suggested diagnosis of 145.9 (Malignant neoplasm of mouth, unspecified) is also appropriate. Remember to include any documentation of the procedure and why reporting an “unlisted” code was the best option.