How To Use CPT Code 42970

CPT 42970 describes the procedure for controlling nasopharyngeal hemorrhage, either primary or secondary, using various techniques such as posterior nasal packs, anterior packs, and/or cautery. 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 42970?

CPT 42970 is used to describe the procedure for controlling nasopharyngeal hemorrhage, which can occur either as a primary condition or as a complication following surgery such as an adenoidectomy. The provider utilizes different techniques to achieve hemostasis in the nasal part of the pharynx, including the use of ribbon gauze or absorbent dressings, bipolar electrocautery, and hot water irrigation.

2. Official Description

The official description of CPT code 42970 is: ‘Control of nasopharyngeal hemorrhage, primary or secondary (eg, postadenoidectomy); simple, with posterior nasal packs, with or without anterior packs and/or cautery.’

3. Procedure

1. The provider performs the procedure to control nasopharyngeal hemorrhage within 24 hours (primary) or up to two weeks (secondary) after surgery, such as an adenoidectomy.
2. Various techniques are used, including the placement of posterior nasal packs, anterior packs, and/or the application of cautery.
3. The provider ensures that the patient is appropriately anesthetized before proceeding with the procedure.
4. Hemostasis is achieved by using ribbon gauze or absorbent dressings, bipolar electrocautery, or hot water irrigation.

4. Qualifying circumstances

CPT 42970 is performed on patients who experience nasopharyngeal hemorrhage, either as a primary condition or as a complication following surgery. The procedure is typically performed within 24 hours (primary) or up to two weeks (secondary) after surgery, such as an adenoidectomy. The provider must use techniques such as posterior nasal packs, anterior packs, and/or cautery to control the bleeding.

5. When to use CPT code 42970

CPT code 42970 should be used when a provider performs the procedure to control nasopharyngeal hemorrhage, either as a primary condition or as a complication following surgery. The procedure involves the use of techniques such as posterior nasal packs, anterior packs, and/or cautery. It is important to note that CPT code 42970 should not be reported for control of bleeding requiring surgical intervention or for control of post-operative oropharyngeal bleeding.

6. Documentation requirements

To support a claim for CPT code 42970, the provider must document the following information:

• Patient’s diagnosis of nasopharyngeal hemorrhage
• Details of the procedure performed, including the use of posterior nasal packs, anterior packs, and/or cautery
• Date of the procedure
• Any complications or adverse events encountered during the procedure
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT code 42970, ensure that the procedure is performed to control nasopharyngeal hemorrhage, either as a primary condition or as a complication following surgery. The use of posterior nasal packs, anterior packs, and/or cautery should be documented. It is important to note that CPT code 42970 should not be reported for control of bleeding requiring surgical intervention or for control of post-operative oropharyngeal bleeding. Additionally, be aware of any bundling rules or modifiers that may apply when reporting this code.

8. Historical information

CPT code 42970 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 patient undergoes an adenoidectomy and experiences nasopharyngeal hemorrhage within 24 hours. The provider performs the procedure using posterior nasal packs and achieves hemostasis.
2. Following a surgery for resection of cancer, a patient develops secondary nasopharyngeal hemorrhage. The provider utilizes cautery to control the bleeding.
3. After an adenoidectomy, a patient presents with persistent bleeding up to two weeks post-surgery. The provider applies both posterior and anterior packs to achieve hemostasis.
4. A patient experiences primary nasopharyngeal hemorrhage and undergoes the procedure with the use of ribbon gauze and hot water irrigation.
5. Following an adenoidectomy, a patient develops secondary nasopharyngeal hemorrhage. The provider performs the procedure using bipolar electrocautery to control the bleeding.
6. During a surgery for resection of cancer, a patient experiences nasopharyngeal hemorrhage. The provider utilizes both posterior nasal packs and cautery to achieve hemostasis.
7. A patient undergoes an adenoidectomy and presents with persistent bleeding within two weeks post-surgery. The provider applies anterior packs and uses hot water irrigation to control the bleeding.
8. Following a surgery for resection of cancer, a patient develops secondary nasopharyngeal hemorrhage. The provider performs the procedure using ribbon gauze and bipolar electrocautery.
9. After an adenoidectomy, a patient experiences primary nasopharyngeal hemorrhage. The provider applies both posterior and anterior packs, achieving hemostasis.
10. A patient presents with persistent bleeding up to two weeks after an adenoidectomy. The provider performs the procedure using hot water irrigation and bipolar electrocautery to control the bleeding.