How To Use CPT Code 92700

CPT 92700 describes an unlisted otorhinolaryngological service or procedure that does not have a specific code. This article will cover the description, official terminology, tips for reporting, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes and billing examples.

1. What is CPT Code 92700?

CPT 92700 can be used to report otorhinolaryngological procedures that do not have a specific code available. It is used when the provider performs a procedure related to the ear, nose, or throat that is not represented by any of the standard and active CPT codes.

2. Official Description

The official description of CPT code 92700 is: ‘Unlisted otorhinolaryngological service or procedure.’

3. Procedure

1. During the procedure, the provider performs an otorhinolaryngological service or procedure that is not covered by any specific CPT code.
2. The procedure may involve diagnostic or therapeutic interventions related to the ear, nose, or throat.
3. The provider should document the details of the procedure, including the specific techniques used and any additional information that may be relevant for proper coding and billing.

4. Qualifying circumstances

CPT 92700 can be used when there is no specific CPT code available to accurately describe the otorhinolaryngological service or procedure performed by the provider. It is important to note that this code should only be used when there is no other appropriate code that closely represents the service provided.

5. When to use CPT code 92700

CPT code 92700 should be used when there is no specific code available to accurately describe the otorhinolaryngological service or procedure performed by the provider. It is important to follow the CPT guidelines and not choose a code that merely approximates the service provided. If a Category III code is available for the procedure, it should be reported instead of using an unlisted procedure code.

6. Documentation requirements

To support a claim for CPT 92700, the provider should include the following documentation:

• A detailed description of the otorhinolaryngological service or procedure performed
• Operative notes or other relevant documentation that provides a clear understanding of the procedure
• A cover letter explaining the reason for choosing the unlisted code and comparing the service to similar codes to justify the claim amount

7. Billing guidelines

When billing for CPT 92700, it is important to submit a cover letter explaining the reason for choosing the unlisted code instead of a defined, active code. Include one or more similar codes and compare the service to those codes to justify the claim amount. Additionally, include the operative notes or other relevant documentation to strengthen the claim and avoid a possible denial. Payers will consider claims with unlisted procedure codes on a case-by-case basis and determine payment based on the documentation provided.

8. Historical information

CPT 92700 was added to the Current Procedural Terminology system on January 1, 2003. There have been no updates to the code since its addition.

9. Examples

1. A provider performs a specialized otorhinolaryngological procedure to address a rare condition affecting the nasal passages.
2. An otolaryngologist performs a complex surgical procedure to reconstruct the middle ear in a patient with a congenital abnormality.
3. A head and neck surgeon performs a unique procedure to remove a tumor from the throat that cannot be classified under any specific CPT code.
4. A provider performs a diagnostic procedure to evaluate the function of the eustachian tube in a patient with chronic ear infections.
5. An otolaryngologist performs a complex revision surgery on a patient who has previously undergone multiple procedures for nasal obstruction.
6. A provider performs a specialized procedure to treat a rare condition affecting the larynx that does not have a specific CPT code.
7. An otolaryngologist performs a complex procedure to repair a defect in the nasal septum that cannot be classified under any specific CPT code.
8. A head and neck surgeon performs a unique procedure to remove a tumor from the paranasal sinuses that does not have a specific CPT code.
9. A provider performs a diagnostic procedure to evaluate the function of the salivary glands in a patient with recurrent swelling and pain.
10. An otolaryngologist performs a complex surgical procedure to reconstruct the trachea in a patient with a traumatic injury.