How To Use CPT Code 40820

CPT 40820 describes the destruction of a lesion or scar in the vestibule of the mouth using various physical methods such as laser, thermal, cryo, or chemical techniques. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 40820?

CPT 40820 can be used to describe the eradication of a lesion or scar present in the vestibule of the mouth using physical methods, excluding excision. The provider utilizes techniques like laser therapy, cryotherapy, or chemical methods to eliminate the lesion or scar without excising it.

2. Official Description

The official description of CPT code 40820 is: ‘Destruction of lesion or scar of vestibule of mouth by physical methods (eg, laser, thermal, cryo, chemical).’ There are no additional notes or modifiers associated with this code.

3. Procedure

1. When performing CPT 40820, the provider begins by appropriately prepping and anesthetizing the patient.
2. Using physical methods such as laser, thermal, cryo, or chemical techniques, the provider destroys the lesion or scar in the vestibule of the mouth.
3. For example, in cryotherapy, the provider applies liquid nitrogen to the site of the lesion, forming ice over it. Over time, the ice destroys and removes the lesion in the mouth.

4. Qualifying circumstances

CPT 40820 is applicable when a patient has a lesion or scar in the vestibule of the mouth that requires destruction. The procedure is performed by a provider using physical methods such as laser, thermal, cryo, or chemical techniques. Excision of a mucosal or submucosal lesion in the vestibule of the mouth should be reported with different codes (40810 to 40816).

5. When to use CPT code 40820

CPT code 40820 should be used when a provider performs the destruction of a lesion or scar in the vestibule of the mouth using physical methods such as laser, thermal, cryo, or chemical techniques. It should not be used for excision procedures or lesions located in other areas of the mouth.

6. Documentation requirements

To support a claim for CPT 40820, the provider must document the following information:

• Patient’s diagnosis and the need for destruction of the lesion or scar
• Specific physical method used (laser, thermal, cryo, or chemical)
• Date of the procedure
• Details of the technique used and the location of the lesion or scar
• Any complications or additional procedures performed
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 40820, ensure that the procedure involves the destruction of a lesion or scar in the vestibule of the mouth using physical methods. It should not be reported with excision codes (40810 to 40816). Additional tips for reporting CPT 40820 may include considering the location of the lesion or scar and the specific physical method used.

8. Historical information

CPT 40820 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates or changes to the code since its addition.

9. Examples

1. A provider using laser therapy to destroy a lesion in the vestibule of the mouth.
2. A patient undergoing cryotherapy to eliminate a scar in the vestibule of the mouth.
3. A provider utilizing chemical methods to eradicate a lesion in the vestibule of the mouth.
4. A scar in the vestibule of the mouth being treated with thermal techniques by a provider.
5. A lesion in the vestibule of the mouth being destroyed using a combination of physical methods by a provider.
6. A patient receiving laser therapy to remove a scar in the vestibule of the mouth.
7. A provider performing cryotherapy to eliminate a lesion in the vestibule of the mouth.
8. A lesion in the vestibule of the mouth being treated with chemical methods by a provider.
9. A provider utilizing thermal techniques to eradicate a scar in the vestibule of the mouth.
10. A combination of physical methods being used by a provider to destroy a lesion in the vestibule of the mouth.