How To Use CPT Code 42809

CPT 42809 describes the removal of a foreign body from the pharynx, which is the part of the throat where the nose passages connect to the trachea and the esophagus. This article will cover the official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 42809?

CPT 42809 is used to describe the procedure of removing a foreign body from the pharynx. This code is used when a healthcare provider uses a tongue depressor and an image intensifier to visualize and locate the foreign particle in the pharynx. The provider then uses a compressing tool to grasp and remove the foreign body.

2. Official Description

The official description of CPT code 42809 is: ‘Removal of foreign body from pharynx.’

3. Procedure

1. After appropriate preparation and anesthesia, the healthcare provider uses a tongue depressor to visualize the pharynx area containing the foreign body.
2. An image intensifier is used to localize the foreign body within the pharynx.
3. The healthcare provider then uses a compressing tool to grasp and remove the foreign body from the pharynx.

4. Qualifying circumstances

CPT 42809 is performed when a patient has a foreign body lodged in their pharynx. The procedure is typically done under appropriate anesthesia to ensure patient comfort. The healthcare provider must use a tongue depressor and an image intensifier to visualize and locate the foreign body. The foreign body must be successfully removed from the pharynx for CPT 42809 to be reported.

5. When to use CPT code 42809

CPT code 42809 should be used when a healthcare provider performs the procedure to remove a foreign body from the pharynx. It is important to note that this code should not be used for the removal of foreign bodies from other areas of the body, such as the ear or nose. In those cases, different CPT codes would be appropriate.

6. Documentation requirements

To support a claim for CPT 42809, the healthcare provider must document the following information:

• Patient’s medical record, including the reason for the procedure
• Details of the procedure, including the use of a tongue depressor, image intensifier, and compressing tool
• Date and time of the procedure
• Description of the foreign body and its successful removal
• Any complications or additional procedures performed
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT 42809, ensure that the procedure involves the removal of a foreign body from the pharynx. It is important to accurately document the details of the procedure and any associated complications. CPT code 42809 should not be reported with other codes unless additional procedures were performed during the same encounter.

8. Historical information

CPT 42809 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 child presents with a small toy lodged in their pharynx. The healthcare provider uses a tongue depressor and an image intensifier to locate and remove the foreign body.
2. An adult accidentally swallows a fishbone, which becomes lodged in their pharynx. The healthcare provider performs the procedure to remove the fishbone using a compressing tool.
3. A patient complains of discomfort in their throat and it is discovered that they have a piece of food stuck in their pharynx. The healthcare provider successfully removes the food particle using a tongue depressor and a compressing tool.
4. A teenager presents with a metal screw stuck in their pharynx. The healthcare provider uses an image intensifier to locate the screw and then removes it using a compressing tool.
5. An elderly patient accidentally inhales a small object, which becomes lodged in their pharynx. The healthcare provider performs the procedure to remove the foreign body using a tongue depressor and an image intensifier.