How To Use CPT Code 42160

CPT 42160 describes the destruction of a lesion on the palate or uvula using techniques such as laser or cryotherapy. 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 42160?

CPT 42160 can be used to describe the procedure in which a healthcare provider removes a lesion on the palate or uvula using techniques like laser or cryotherapy. This code is used when the provider destroys the lesion on the palate or uvula using extreme cold or heat, resulting in its removal.

2. Official Description

The official description of CPT code 42160 is: ‘Destruction of lesion, palate or uvula (thermal, cryo or chemical).’ This code is used when the provider destroys a lesion on the palate or uvula using techniques such as laser ablation, cryotherapy, or chemical methods.

3. Procedure

1. The healthcare provider prepares the patient and administers anesthesia if necessary.
2. Using techniques like laser ablation, cryotherapy, or chemical methods, the provider destroys the lesion on the palate or uvula.
3. If cryotherapy is used, the provider applies liquid nitrogen at approximately -200 degrees Celsius to freeze and destroy the lesion.
4. After the procedure, the provider flushes the site with saline solution and applies antibiotics to prevent infection.

4. Qualifying circumstances

CPT 42160 is used when a patient has a lesion on the palate or uvula that requires destruction. The lesion can be any area of damaged or diseased tissue. The procedure is performed by a healthcare provider using techniques such as laser ablation, cryotherapy, or chemical methods.

5. When to use CPT code 42160

CPT code 42160 should be used when a healthcare provider performs the destruction of a lesion on the palate or uvula using techniques like laser ablation, cryotherapy, or chemical methods. This code should not be used for excision of lesions on the palate or uvula, as there are separate codes for those procedures.

6. Documentation requirements

To support a claim for CPT 42160, the healthcare provider must document the following information:

• Patient’s diagnosis and the need for lesion destruction
• Specific technique used for lesion destruction (laser ablation, cryotherapy, or chemical methods)
• Date of the procedure
• Details of the procedure, including the use of anesthesia if applicable
• Post-procedure care, such as flushing the site with saline solution and applying antibiotics
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT 42160, ensure that the healthcare provider performs the destruction of the lesion on the palate or uvula using techniques like laser ablation, cryotherapy, or chemical methods. This code should not be reported with excision codes for lesions on the palate or uvula. It is important to consider the location of the lesion and the specific technique used for accurate coding.

8. Historical information

CPT 42160 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates to the code since its addition.

9. Examples

1. A healthcare provider using laser ablation to destroy a lesion on the palate.
2. A provider performing cryotherapy to remove a lesion on the uvula.
3. A healthcare professional using chemical methods to destroy a lesion on the palate.
4. A provider using laser ablation to remove a lesion on the uvula.
5. A healthcare professional performing cryotherapy to destroy a lesion on the palate.
6. A provider using chemical methods to remove a lesion on the uvula.
7. A healthcare professional using laser ablation to destroy multiple lesions on the palate.
8. A provider performing cryotherapy to remove multiple lesions on the uvula.
9. A healthcare professional using chemical methods to destroy multiple lesions on the palate.
10. A provider using laser ablation to remove multiple lesions on the uvula.