OTOLARYNGOLOGY-HEAD AND NECK SURGERY PROCEDURE BUNDLES / CPT

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OTOLARYNGOLOGY-HEAD AND NECK SURGERY

PROCEDURE BUNDLES / CPT

LEVEL I – CORE PRIVILEGES

CPT

EVALUATION & CLINICAL CARE

Admit, Consult, H&P, Orders.

Laryngoscopy 31505-31579

Esophagoscopy 43200-43232

Bronchoscopy 31622-31656

Nasendoscopy 31231-31294

Examination Under Anesthesia 92502

Incisional and Debridement 10060

Remove Foreign Body 10120

Drainage Hematoma, Seroma 10140

Debridement Skin or Wound 11000

Repair Laceration in Layers 12032

Biopsy Lesion (Shave, Punch, Incisional, Excisional) 11402

Incisional Biopsy, Malignant Lesion 11100

Biopsy Lymph Node 38500

ENDOSCOPY

Laryngoscopy - Laser 31545

Bronchoscopy - Laser 31641

Nasendoscopy-Laser

Endoscopic Creation of Speaking Tracheo-Esophageal Fistula 31611

FACIAL FRACTURES/CRANIOMAXILLOFACIAL

Reduction of Nasal Fracture - Closed 21310

Reduction of Nasal Fracture - Open 21325

Placement of Arch Bars - With or Without IMF 21453

Removal of Arch Bars 20694

Reduction of Mandibular Fracture - Closed 21440 Reduction of Mandibular Fracture - Open 21462

Reduction of Zygomatic Fracture 21356

Reduction of Malar Complex (Trimalar) Fracture 21360

Orbital Floor Exploration 67400

Reduction of Nasoethmoid Fracture 21340

Reduction of Complex Maxillary Fracture (Le Fort 1) 21346 Reduction of Complex Maxillary Fracture (Le Fort 2) 21422 Reduction of Complex Maxillary Fracture (Le Fort 3) 21432

Bone or Cartilage Graft 20902

Genioplasty (Not Cosmetic) 21199

Chin Implant 21120

Facial Injection or Grafting 15770

Facial Osteotomy / Genioplasty 21121

Malar Implant 21270

Malar Implant with Bone Graft Use 21210

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GRAFTS / FLAPS

Split Thickness Skin Graft 15120_3

Full Thickness Skin Graft 15135_3

Dermal Graft 15135

Cartilage Graft 21235

Bone Graft 21210

Local Skin Flap Reconstruction 15740

Lip Flap Reconstruction 40527

Pectoralis Myocutaneous Flap 15732

Deltopectoral Flap 15732

Forehead and/or Scalp Pedicle Flap 15630

Trapezius Myocutaneous Flap 15650

Facial Sling 15840 Latisimus

LARYNX / TRACHEA

Tracheostomy 31600 Laryngofissure – Thyrotomy 31300 Arytenoidectomy 31400 Cordectomy 31300 Supraglottic Laryngectomy 31367 Hemilaryngectomy 31370 Total Laryngectomy 31360

Exploration and/or Repair of Laryngeal Fractures 31584

NECK

Incision & Drainage of Neck Abscess 21501

Neck Exploration 38542

Excision of Thyroglossal Duct Cyst 60280

Excision of Branchial Cleft Cyst 42815

Excision of Carotid Body Tumor 60600

Excision of Other Neck Lesion 21555

Cervical Node Biopsy 38510

Radical Neck Dissection 38720

Modified Radical Neck Dissection 38724

Selective Neck Dissection 38510

Supraomohyoid Neck Dissection 38700

Thyroid Lobectomy 60220

Thyroid Lobectomy With Isthmusectomy 60210

Subtotal Thyroidectomy 60271

Total Thyroidectomy 60240

Parathyroidectomy 60500

Reimplantation of Parathyroid 60512

Ligation of Major Vessel 37615

Diverticulectomy 43130

Cricopharyngeal Myotomy 43130

Superficial Parotidectomy 42410

Total Parotidectomy 42420

Submandibular Gland Excision 42440

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NOSE / MAXILLA / SINUS

Foreign Body Removal from the Nose 30310

Excision of Intranasal Tumor 30117

Nasal Polypectomy 30115 Septoplasty 30520 Septoplasty / rhinoplasty 30420 Lateral Rhinotomy 30118 Medial Maxillectomy 31225 Radical Maxillectomy 31230 Orbital Exenteration 65110_3 Dacrocystorhinostomy 68720_3 Partial Rhinectomy 30150 Total Rhinectomy 30160 Turbinate Reduction 30140 Nasal Reconstructon 30465

Antrotomy With or Without Lavage 31020

Caldwell-Luc 31020

Transantral Ligation of Vessels 30920

ESS - Ethmoidectomy 31255

ESS - Sphenoid Sinusotomy 31287

ESS - Antrotomy 31256

ESS - Frontal Sinusotomy 31276

External Ethmoidectomy 31205

Frontoethmoidectomy 31090

Frontal Sinus Trephine 31070

Osteoplastic Frontal Sinusotomy 31085

Frontal Sinus Ablation 31081

Orbital Decompression 31292

Nasal Reconstruction (Including Septum and External Nose) 30462

ORAL CAVITY / PALATE / NASOPHARYNX

Tonsillectomy 42825

Adenoidectomy 42830

Palatopharyngoplasty 42145

Palatectomy - Partial or Total 42120

Resection of Nasopharyngeal Tumor 42804

Partial Glossectomy 41130

Total Glossectomy 41140

Partial Mandibulectomy 21044

Composite Resection 41155

Local Excision of Oral Cavity Lesion 40810 Laser Excision of Oral Cavity Lesion 40820

Excision of Floor of Mouth 41116

Oroantral Fistula Repair 30600

Choanal Atresia Repair 30540

Dental Extraction with Mandibular Fracture 41899

Mandibular Reconstruction 21245

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OTOLOGIC

Myringotomy With or Without Insertion of PET’s 69433 Tympanoplasty Without Ossiculoplasty 69643

Tympanoplasty With Ossiculoplasty 69642

Tympanoplasty With Mastoidectomy 69641

Cortical Mastoidectomy 69502

Modified Radical Mastoidectomy 69505

Meatoplasty 69310

Excision of External Auditory Canal Tumor 69145

Excision of Mastoid Tumor 69502

Excision of Middle Ear Tumor 69799

Ossicular Reconstruction 69636

Auriculectomy 69120

Canaloplasty 69310

Drainage of Abscess or Hematoma 69000

Foreign Body Removal from the Ear 69200

Facial Nerve Repair, Graft or Interposition 69740 Construction / Reconstruction of Auricle 21230

Otoplasty 69300

Ear Examination Under Anesthesia 92502

COSMETIC

Blepharoplasty - Upper 15823_3

Blepharoplasty - Lower 15821_3

Brow Lift 67900_3

Buccal Fat Excision 15839

Cheek Lift 15828

Chin Implant 21120

Facial Injection or Grafting 15840

Facial Osteotomy / Genioplasty 21198

Liposuction - Face 15876 Mandibular Implant 21125 Malar Implant 21270 Otoplasty 69300 Rhinoplasty 30400 Rhytidectomy 15828 Submental Lipectomy 15838

Surgical Treatment of Ear Keloid 11442

Temporal Lift 15824

Chemical Peel 15788

Dermabrasion 15780

Laser Resurfacing 17004

Scar Revision - Complex 11444

Scar revision - Simple 11440

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SKIN AND SOFT TISSUE (SST)

Incision & Drainage of Cutaneous Abscess or Hematoma 10060

Removal of Foreign Body 10120

Debridement of Wound – Simple 11000

Debridement of Wound – Complex 11010

Repair of Laceration – Simple 12011

Repair of Laceration – Complex 13131

Excision of Lip Lesion 40510

Biopsy of Skin Lesion 11400

Excision of Benign Skin Lesion 11420

Excision of Malignant Skin Lesion 11620

Reconstruction of Eyelids 67971

Tarrsoraphy 67875

Gold Weight Insertion to the Eyelid 67911

Lateral Canthopexy 67950

Ptosis Repair 67901

Filler/Implant Hair Flaps/Grafts

Static Procedures for Facial Palsy 15840

Scar Revision (Not Cosmetic) 14040

Mid-Face Lift (Not Cosmetic) 15828

Rhytidectomy (Not Cosmetic) 15829

Surgical Treatment of Ear Keloid 11433

Repair Soft Tissue Injury 13153

Repair Lacrimal Duct 68700

Repair Eyelid Laceration 65273

Repair Ear Superficial 13160

Repair Ear Complex 16160

Acute Debridement and Grafting, Burns 16030 Late Reconstruction, Burns

Scar Revision, Complex Depends on Site Size 14000-14302 Scar Revision, Simple Depends on Site Size 13100-13153

Surgical Treatment of Keloid 12031

Split Thickness Skin Graft 15120

Full Thickness Skin Graft 15200

Skin and Fascial Flaps 14060

Tissue Expansion 19357

Excision Benign Lesions, Head and Neck 11420

Excision Benign Lesions, Elsewhere 11400

Excision Malignant Lesion, Head and Neck 11620

Chemical Peel (Not Cosmetic) 15788

Dermabrasion (Not Cosmetic) 15780

Fat Grafting (Not Cosmetic) 15770

LASER

CO2

KTP Erbium Etc

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LEVEL II – ADVANCED PRIVILEGES

MICROVASCULAR

Free Tissue Transfer 41155

LARYNX / TRACHEA

Denervation of Recurrent Laryngeal Nerve 31595 Reinnervation of Recurrent Laryngeal Nerve 31590

Laryngoplasty 31588

Tracheoplasty 31750

Segmental Tracheal Resection 31780

OTOLOGIC

Stapedectomy 69660

Vestibular Nerve Section 69915

Acoustic Neuroma Resection 69970

CSF Leak Repair 61618

Labyrinthectomy 69905

Excision of Skull Base Tumor 69970

Cochlear Implantation 69930

Temporal Bone Resection 69535

Facial Nerve Decompression 69955

CRANIOMAXILLFACIAL

Cleft Lip Repair, Unilateral 40700

Cleft Lip Repair, Bilateral 40701

Cleft Palate Repair 42200

Primary Cleft Lip Rhinoplasty 40700

Secondary Repair Cleft Lip 40720

Secondary Cleft Lip Rhinoplasty 30460

Alveolar Bone Graft 42210

Palatal Fistula Repair 42260

Pharyngeal Flap or Pharyngoplasty 42225

Other Facial Cleft Repair 40700

Reconstruction Microtic Ear, 1st Stage 21230 Reconstruction Microtic Ear, Subsequent Stage 21230

Correction Eyelid Ptosis 15822

Mandibular Osteotomy 21195

Placement Mandibular Craniofacial Distraction Device 21110 Remove Mandibular Craniofacial Distraction Device 20694

Maxillary Osteotomy 21141

Placement Maxillary / Craniofacial Distraction Device 21110 Remove Maxillary / Craniofacial Distraction Device 20694

Major Craniofacial Reconstruction 21175

Liposuction for Congenital Asymmetry 15830

Dynamic Procedures for Facial Palsy 15732

Facial Re-Innervation 15842

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