How To Use CPT Code 41512

CPT 41512 describes a procedure known as tongue base suspension, which is used to enlarge the retrolingual airway and prevent obstruction during sleep. This article will cover the description, official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 41512?

CPT 41512 is a code that represents a surgical procedure called tongue base suspension. This procedure is performed under general anesthesia and involves the placement of sutures through the tongue base to pull it anteriorly. The sutures are then fixed to a screw on the inner table of the mandible. The goal of this procedure is to enlarge the retrolingual airway and prevent obstruction during sleep, making it a surgical treatment for sleep apnea.

2. Official Description

The official description of CPT code 41512 is: ‘Tongue base suspension, permanent suture technique.’

3. Procedure

Tongue base suspension is performed under general anesthesia. The surgeon places sutures through the tongue base to pull it anteriorly. These sutures are then fixed to a screw on the inner table of the mandible. The procedure can be approached intraorally or submentally. The goal of tongue base suspension is to enlarge the retrolingual airway and prevent obstruction during sleep, providing a surgical treatment for sleep apnea.

4. Qualifying circumstances

Tongue base suspension is typically performed on patients with obstructive sleep apnea (OSA), a condition characterized by temporary pauses in breathing during sleep. Long-term OSA can lead to cardiovascular problems. This procedure is suitable for patients who have not responded to other treatments for sleep apnea, such as continuous positive airway pressure (CPAP) therapy. It is important to note that prior approval may be required by the payer for this procedure.

5. When to use CPT code 41512

CPT code 41512 should be used when performing tongue base suspension using a permanent suture technique. It is important to ensure that the procedure is medically necessary and appropriate for the patient’s condition. This code should not be used for other procedures on the tongue and floor of the mouth that have different techniques or objectives.

6. Documentation requirements

To support a claim for CPT code 41512, the following documentation is typically required:

• Documentation of the patient’s diagnosis and the medical necessity of the procedure
• Description of the specific technique used for tongue base suspension
• Date of the procedure
• Details of the procedure, including the approach (intraoral or submental) and any additional relevant information
• Any complications or unexpected findings during the procedure
• Signature of the performing surgeon

7. Billing guidelines

When billing for CPT code 41512, it is important to ensure that the procedure is performed by a qualified healthcare professional and that the documentation supports the medical necessity of the procedure. It is also important to follow any prior approval requirements set by the payer. It is recommended to review the payer’s preferences for reporting other procedures related to sleep apnea and snoring, as there may be specific codes or modifiers to use in conjunction with CPT code 41512.

8. Historical information

CPT code 41512 was added to the Current Procedural Terminology system on January 1, 2009. There have been no updates to the code since its addition.

9. Similar codes to CPT 41512

Five similar codes to CPT 41512 include:

• CPT 41510: Suture of tongue to lip for micrognathia
• CPT 41513: Suspension of hypopharynx
• CPT 41514: Suspension of epiglottis
• CPT 41515: Suspension of larynx
• CPT 41516: Suspension of pharynx

9. Examples

1. A patient with severe obstructive sleep apnea undergoes tongue base suspension to enlarge the retrolingual airway and prevent obstruction during sleep.
2. A surgeon performs tongue base suspension on a patient who has not responded to other treatments for sleep apnea, such as CPAP therapy.
3. A patient with a history of cardiovascular problems undergoes tongue base suspension to address their obstructive sleep apnea.
4. A surgeon performs tongue base suspension using a permanent suture technique on a patient with a diagnosis of sleep apnea.
5. A patient with a severe case of sleep apnea undergoes tongue base suspension to improve their breathing during sleep.
6. A surgeon performs tongue base suspension on a patient who has experienced complications from other treatments for sleep apnea.
7. A patient with a history of snoring and daytime sleepiness undergoes tongue base suspension to address their sleep apnea symptoms.
8. A surgeon performs tongue base suspension on a patient with a diagnosis of obstructive sleep apnea and a narrow retrolingual airway.
9. A patient with a severe case of sleep apnea undergoes tongue base suspension to reduce the frequency and severity of their breathing pauses during sleep.
10. A surgeon performs tongue base suspension on a patient who has failed to achieve adequate improvement with other non-surgical treatments for sleep apnea.