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Otolaryngology CPT Codes Reference

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📋Otolaryngology CPT Codes Reference

What This MOC Covers

This reference index covers the major CPT code families in Otolaryngology (ENT) — organized by anatomic region and procedure type. Use this note to navigate to individual procedure notes, identify correct code selection within a family, understand bundling rules, and locate modifier and global period guidance. Codes span the Ear, Nose, Throat, Larynx, Trachea, Salivary Glands, and Head/Neck Surgery sections of CPT.

💰 Anatomic Navigation Index

👂🏾 Ear — External Ear

CPTDescriptionGlobalNotes
69000Drainage of external ear, abscess or hematoma; simple010Incision and drainage, external auditory canal
69005Drainage of external ear, abscess or hematoma; complicated010Deep or complex EAC abscess
69020Drainage of external auditory canal, abscess010Canal abscess
69090Ear piercing000Minor procedure
69100Biopsy of external ear000Skin or cartilage biopsy
69105Biopsy of external auditory canal000EAC lesion biopsy
69110Excision of external ear, partial, simple repair090Partial auriculectomy
69120Excision of external ear, complete amputation090Total auriculectomy
69140Excision, exostosis of external auditory canal090Surfer’s ear
69145Excision, soft tissue lesion, external auditory canal090EAC soft tissue
69150Radical excision, external auditory canal lesion, without neck dissection090Malignant EAC lesion
69155Radical excision of external auditory canal lesion, with neck dissection090With LND
69200Removal of foreign body, external auditory canal; without general anesthesia000FB removal, office
69205Removal of foreign body, external auditory canal; with general anesthesia000FB removal, OR
69209Removal of impacted cerumen, irrigation or instrumentation; unilateral000Lavage/irrigation only
69210Removal of impacted cerumen requiring instrumentation; unilateral000Curette/suction; bilateral = -50
69220Debridement, mastoidectomy cavity; simple010Mastoid bowl cleaning
69222Debridement, mastoidectomy cavity; complex010Extensive debridement
69300Otoplasty090Cosmetic/reconstructive ear pinning

👂🏾 Ear — Middle Ear

Myringotomy and Tube Insertion

CPTDescriptionGlobalNotes
69420Myringotomy including aspiration and/or Eustachian tube inflation010No tube inserted
69421Myringotomy including aspiration, with general anesthesia010Aspiration under GA, no tube
69433Tympanostomy, local or topical anesthesia010Tube insertion, local anesthesia — office
69436Tympanostomy, general anesthesia010Tube insertion under GA; bilateral = -50
69440Middle ear exploration through postauricular or ear canal incision090Exploration
69450Tympanolysis, transcanal090Lysis of tympanic membrane adhesions

Tympanoplasty

CPTDescriptionGlobalNotes
69610Tympanic membrane repair, with or without site preparation of perforation for closure, with or without patch090Simple patch repair
69620Myringoplasty (Type I tympanoplasty)090Graft-only repair, no ossicular work
69631Tympanoplasty without mastoidectomy; with ossicular chain reconstruction090Includes PORP
69632Tympanoplasty without mastoidectomy; with ossicular chain reconstruction and synthetic prosthesis090TORP or synthetic
69633Tympanoplasty without mastoidectomy; with perilymph fistula repair090Fistula repair
69635Tympanoplasty with antrotomy or mastoidotomy; without ossicular chain reconstruction090With antral work, no ossicles
69636Tympanoplasty with antrotomy or mastoidotomy; with ossicular chain reconstruction090With ossicular work
69637Tympanoplasty with antrotomy or mastoidotomy; with ossicular chain reconstruction and synthetic prosthesis090Synthetic prosthesis
69641Tympanoplasty with mastoidectomy; without ossicular chain reconstruction090Mastoidectomy + TMP
69642Tympanoplasty with mastoidectomy; with ossicular chain reconstruction090Full reconstruction
69643Tympanoplasty with mastoidectomy; intact or reconstructed canal wall, without ossicular chain reconstruction090CWU mastoidectomy
69644Tympanoplasty with mastoidectomy; intact or reconstructed canal wall, with ossicular chain reconstruction090CWU + ossicular
69645Tympanoplasty with mastoidectomy; radical or complete, without ossicular chain reconstruction090CWD mastoidectomy
69646Tympanoplasty with mastoidectomy; radical or complete, with ossicular chain reconstruction090CWD + ossicular

Middle Ear Other

CPTDescriptionGlobalNotes
69650Stapes mobilization090For otosclerosis — rare
69660Stapedectomy or stapedotomy090Prosthetic stapes
69661Stapedectomy or stapedotomy with reestablishment of ossicular continuity with or without use of foreign material090Full reconstruction
69662Revision of stapedectomy or stapedotomy090Revision surgery
69666Repair of oval window fistula090Oval window
69667Repair of round window fistula090Round window
69670Mastoid obliteration (separate procedure)090Cavity obliteration
69676Tympanic neurectomy090Jacobson nerve — for Frey syndrome, parotid hyper-secretion

Epistaxis/Nasopharyngeal Hemorrhage from Ear Surgery

CPTDescriptionNotes
42960Control of nasopharyngeal hemorrhage; simplePost-tonsillectomy bleed, simple
42961Control of nasopharyngeal hemorrhage; requiring hospitalizationRequiring admission
42962Control of nasopharyngeal hemorrhage; with secondary surgical interventionReturn to OR

👂🏾 Ear — Inner Ear

CPTDescriptionGlobalNotes
69801Labyrinthotomy, with perfusion of vestibuloactive drug(s), transcanal090Gentamicin/steroid perfusion — Meniere’s
69802Labyrinthotomy, with perfusion of vestibuloactive drug(s); with mastoidotomy090With mastoid access
69805Endolymphatic sac operation; without shunt090Meniere’s surgical treatment
69806Endolymphatic sac operation; with shunt090With drainage shunt
69820Fenestration semicircular canal090Rare
69840Revision of fenestration operation090Revision
69905Labyrinthectomy; transcanal090Destructive — severe Meniere’s
69910Labyrinthectomy; with mastoidectomy090With mastoid access
69930Cochlear device implantation, with or without mastoidectomy090Cochlear implant (CI) surgery

👂🏾 Ear — Temporal Bone and Mastoid

CPTDescriptionGlobalNotes
69501Transmastoid antrotomy (simple mastoidectomy)090Simple mastoidectomy
69502Mastoidectomy without tympanoplasty090Canal wall up, no TMP
69505Mastoidectomy with tympanoplasty090Combined approach
69511Mastoidectomy radical090Canal wall down — radical
69530Petrous apicectomy including radical mastoidectomy090Petrous apex
69535Resection of temporal bone, external approach090Temporal bone resection — malignancy
69554Ablation of lateral semicircular canal; with mastoidectomy090Labyrinthine surgery

👃🏾Nose — Incision, Drainage, Biopsy

CPTDescriptionGlobalNotes
30000Drainage of nasal abscess or hematoma; internal approach010Septal hematoma drainage
30020Drainage of nasal abscess or hematoma; external approach010External approach
30100Biopsy, intranasal000Office biopsy, nasal mucosa or lesion
30110Excision of nasal polyp(s), simple010Simple office polypectomy
30115Excision of nasal polyp(s), extensive090Extensive polypectomy, OR
30117Excision or destruction, intranasal lesion; internal approach010Benign lesion excision
30118Excision or destruction, intranasal lesion; external approach090External rhinotomy approach
30124Excision dermoid cyst, nose; simple, not involving the nasal bone010Superficial dermoid
30125Excision dermoid cyst, nose; complex, with osteotomies090Deep dermoid, bone work

👃Nose — Excision and Repair

CPTDescriptionGlobalNotes
30400Rhinoplasty; primary, tip only090Cosmetic — tip plasty
30410Rhinoplasty; primary, except tip090Cosmetic — dorsum/bridge
30420Rhinoplasty; primary, including major septal repair090Cosmetic with septal work
30430Rhinoplasty; secondary, minor revision090Minor revision rhinoplasty
30435Rhinoplasty; secondary, intermediate revision090Intermediate revision
30450Rhinoplasty; secondary, major revision090Major revision rhinoplasty
30460Rhinoplasty for nasal deformity secondary to congenital cleft lip and/or palate; tip only090Cleft nose repair, tip
30462Rhinoplasty for nasal deformity secondary to congenital cleft lip/palate; tip, septum, osteotomies090Full cleft nose repair
30465Repair of nasal vestibular stenosis090Stenosis repair

Tip

⚠️ Functional Rhinoplasty Note: Cosmetic rhinoplasty (30400-30450) is generally not covered by Medicare or most commercial insurers unless performed for documented functional impairment. Always append documentation of functional deficit when billing rhinoplasty for obstruction.

Nose — Septum

CPTDescriptionGlobalNotes
30520Septoplasty or submucous resection, with or without cartilage scoring, contouring or replacement with graft090Functional septoplasty — most commonly billed septum CPT
30600Repair of nasoseptal perforation090Septal perforation closure
30630Repair of nasal septal perforations090Complex perforation repair

Tip

⚠️ Septoplasty coding note: 30520 is the standard code for functional septoplasty. Rhinoplasty codes (30420) are used when major cosmetic nasal reshaping accompanies the septal repair. Do not use 30420 for purely functional correction of deviation.

Nose — Turbinates

CPTDescriptionGlobalNotes
30130Excision inferior turbinate, partial or complete, any method010Partial or complete turbinate excision
30140Submucous resection inferior turbinate, partial or complete, unilateral or bilateral010Submucous resection — most commonly reported; separately reportable from 30520
30801Ablation, soft tissue of inferior turbinates, unilateral or bilateral; superficial010Radiofrequency or laser superficial ablation
30802Ablation, soft tissue of inferior turbinates, unilateral or bilateral; intramural010Intramural radiofrequency — somnoplasty-type
30930Fracture nasal inferior turbinate(s), therapeutic010Outfracture or infracture

Tip

⚠️ Turbinate billing note: Turbinate procedures are separately reportable when performed in conjunction with septoplasty (30520). The operative note must describe the turbinate procedure as a distinct, intentional surgical step with a separately documented indication. Do not bill turbinate codes for incidental repositioning only.

Nose — Epistaxis Control

CPTDescriptionGlobalNotes
30901Control of nasal hemorrhage, anterior, simple (limited cautery and/or packing) any method010Initial anterior — office or ED
30903Control of nasal hemorrhage, anterior, complex (extensive cautery and/or packing) any method010Subsequent/complex anterior
30905Control of nasal hemorrhage, posterior, with posterior nasal packs and/or cautery, any method; initial service010Posterior nasal packing or balloon catheter
30906Control of nasal hemorrhage, posterior; subsequent service010Follow-up posterior bleed management
30999Unlisted procedure, noseN/AUsed for endoscopic SPA ligation — see 31238
31238Nasal/sinus endoscopy, surgical; with control of nasal hemorrhage010Endoscopic hemorrhage control — SPA cautery

Nose — Nasal Endoscopy (FESS)

FESS Building-Block Coding Model

FESS codes are additive — each anatomic sinus opened and treated is separately reported. Each code builds upon the prior:

CPTDescriptionGlobalNotes
31231Nasal endoscopy, diagnostic, unilateral or bilateral (separate procedure)000Diagnostic only — NOT reported when surgical FESS performed
31233Nasal/sinus endoscopy, diagnostic; with maxillary sinusoscopy000Diagnostic with maxillary visualization
31235Nasal/sinus endoscopy, diagnostic; with sphenoid sinusoscopy000Diagnostic with sphenoid
31237Nasal/sinus endoscopy, surgical; with biopsy, polypectomy or debridement010Surgical endoscopy with tissue
31238Nasal/sinus endoscopy, surgical; with control of nasal hemorrhage010Endoscopic hemorrhage — SPA
31239Nasal/sinus endoscopy, surgical; with dacryocystorhinostomy090Endoscopic DCR
31240Nasal/sinus endoscopy, surgical; with concha bullosa resection010Middle turbinate air cell
31241Nasal/sinus endoscopy, surgical; with ligation of sphenopalatine artery010SPA ligation
31254Nasal/sinus endoscopy, surgical; with ethmoidectomy, partial (anterior)090Anterior ethmoidectomy only
31255Nasal/sinus endoscopy, surgical; with ethmoidectomy, total (anterior and posterior)090Total ethmoidectomy — most common
31256Nasal/sinus endoscopy, surgical; with maxillary antrostomy090Maxillary antrostomy without tissue removal
31267Nasal/sinus endoscopy, surgical; with maxillary antrostomy, with removal of tissue from maxillary sinus090Maxillary antrostomy with tissue removal — most commonly billed maxillary code
31276Nasal/sinus endoscopy, surgical; with frontal sinus exploration, with or without removal of tissue090Frontal sinusotomy
31287Nasal/sinus endoscopy, surgical; with sphenoidotomy090Sphenoid sinusotomy
31288Nasal/sinus endoscopy, surgical; with sphenoidotomy, with removal of tissue090Sphenoid with tissue removal
31295Nasal/sinus endoscopy, surgical; dilation of maxillary sinus ostium (balloon)090Balloon sinuplasty — maxillary
31296Nasal/sinus endoscopy, surgical; dilation of frontal sinus ostium (balloon)090Balloon sinuplasty — frontal
31297Nasal/sinus endoscopy, surgical; dilation of sphenoid sinus ostium (balloon)090Balloon sinuplasty — sphenoid
31298Nasal/sinus endoscopy, surgical; dilation of frontal and sphenoid sinus ostia (balloon)090Balloon sinuplasty — frontal + sphenoid

FESS Bundling and Modifier Rules:

  • Each sinus code is reported separately for the sinuses treated.
  • Modifier -50 when the same sinus procedure is performed bilaterally.
  • Modifier -51 for the secondary lower-value procedure when multiple different FESS codes are reported.
  • 31231 (diagnostic endoscopy) is NOT separately billable when any surgical endoscopy code is used — bundled.
  • Balloon sinuplasty (31295-31298) and conventional FESS codes (31254-31288) may be reported together when both approaches are used in the same session for different sinuses.

Larynx and Trachea

Laryngoscopy

CPTDescriptionGlobalNotes
31505Laryngoscopy, indirect; diagnostic000Mirror exam
31510Laryngoscopy, indirect; with biopsy000Mirror with tissue
31511Laryngoscopy, indirect; with removal of foreign body000FB removal
31512Laryngoscopy, indirect; with removal of lesion000Lesion removal
31520Laryngoscopy, direct, diagnostic; newborn000Newborn airway exam
31525Laryngoscopy, direct, diagnostic; except newborn000Direct diagnostic
31526Laryngoscopy, direct, diagnostic; with operating microscope or telescope000Micro-laryngoscopy, diagnostic
31527Laryngoscopy, direct; with insertion of obturator000Obturator placement
31528Laryngoscopy, direct; with dilation, initial000Initial dilation
31529Laryngoscopy, direct; with dilation, subsequent000Subsequent dilation
31530Laryngoscopy, direct; with removal of foreign body090OR foreign body
31531Laryngoscopy, direct; with removal of foreign body, with operating microscope or telescope090Micro with FB
31535Laryngoscopy, direct; with biopsy090Biopsy under direct scope
31536Laryngoscopy, direct; with biopsy, with operating microscope or telescope090Micro-laryngoscopy with biopsy
31540Laryngoscopy, direct; with excision of tumor and/or stripping of vocal cords or epiglottis090Tumor excision or cord stripping
31541Laryngoscopy, direct; with excision of tumor, with operating microscope or telescope090Micro-laryngoscopy, tumor excision
31545Laryngoscopy, direct; with vocal cord injection, with operating microscope or telescope090Cord injection — vocal cord medialization
31546Laryngoscopy, direct; with vocal cord injection, with operating microscope or telescope, with computer-assisted planning090With navigation
31551Laryngoplasty for laryngeal stenosis; with graft, without indwelling stent placement090Laryngeal reconstruction
31552Laryngoplasty for laryngeal stenosis; with graft, with indwelling stent placement090With stent
31553Laryngoplasty for laryngeal stenosis; with graft, without indwelling stent placement, age 12 and under090Pediatric
31554Laryngoplasty for laryngeal stenosis; with graft, with indwelling stent placement, age 12 and under090Pediatric with stent
31560Laryngoscopy, direct; with arytenoidectomy090Arytenoid removal — bilateral cord paralysis
31561Laryngoscopy, direct; with arytenoidectomy, with operating microscope or telescope090Micro-arytenoidectomy
31571Laryngoscopy, direct, operative; with injection of inert material for unilateral vocal cord paralysis090Injection medialization
31572Laryngoscopy, direct, operative; with ablation of laryngeal lesion using laser090Laser ablation — papilloma, tumor
31573Laryngoscopy, flexible, therapeutic; with injection(s) for chemodenervation000In-office Botox vocal cord
31574Laryngoscopy, flexible, therapeutic; with injection of inert material000In-office injection medialization
31575Laryngoscopy, flexible; diagnostic000Flexible fiberoptic laryngoscopy — office
31576Laryngoscopy, flexible; with biopsy000Flexible with biopsy
31577Laryngoscopy, flexible; with removal of foreign body000Flexible with FB
31578Laryngoscopy, flexible; with removal of lesion000Flexible with lesion
31579Laryngoscopy, flexible or rigid telescopic; with stroboscopy000Videostroboscopy — voice evaluation

Laryngectomy

CPTDescriptionGlobalNotes
31300Laryngotomy (thyrotomy, laryngofissure)090Open larynx — rare
31360Laryngectomy; total, without radical neck dissection090Total laryngectomy, no RND
31365Laryngectomy; total, with radical neck dissection090Total + radical neck
31367Laryngectomy; subtotal supraglottic, without radical neck dissection090Supraglottic
31368Laryngectomy; subtotal supraglottic, with radical neck dissection090Supraglottic + radical neck
31370Partial laryngectomy (hemilaryngectomy); horizontal090Horizontal partial
31375Partial laryngectomy; lateralizing cartilage resection090Lateralizing
31380Partial laryngectomy; antero-lateral vertical partial090Frontolateral
31382Partial laryngectomy; antero-lateral vertical partial, with radical neck dissection090With RND
31390Pharyngolaryngectomy, with radical neck dissection; without reconstruction090Extensive resection
31395Pharyngolaryngectomy, with radical neck dissection; with reconstruction090With free flap or reconstruction
31611Construction of tracheoesophageal fistula and subsequent insertion of alaryngeal speech prosthesis090TEP — separately reportable from laryngectomy

Trachea

CPTDescriptionGlobalNotes
31600Tracheostomy, planned (separate procedure)090Elective open tracheostomy
31601Tracheostomy, planned; younger than 2 years090Pediatric tracheostomy
31603Tracheostomy, emergency procedure; transtracheal010Emergency needle cricothyrotomy
31605Tracheostomy, emergency procedure; cricothyroid membrane010Surgical cricothyrotomy
31610Tracheostomy, fenestration procedure with skin flaps090Permanent tracheostomy with flaps
31611Construction of tracheoesophageal fistula090TEP placement
31612Tracheal puncture, percutaneous with transtracheal aspiration and/or injection000Percutaneous aspiration
31613Tracheostoma revision; simple, without flap rotation090Stoma revision
31614Tracheostoma revision; complex, with flap rotation090Complex stoma revision
31615Tracheobronchoscopy through established tracheostomy incision000Scope through stoma
31622Bronchoscopy, rigid or flexible, including fluoroscopic guidance when performed; diagnostic000Diagnostic bronchoscopy
31625Bronchoscopy; with biopsy000Bronchoscopy with tissue

Pharynx and Adenoids

CPTDescriptionGlobalNotes
42700Incision and drainage of peritonsillar abscess010PTA I&D — office or ED
42720Incision and drainage of retropharyngeal abscess; intraoral approach090Retropharyngeal abscess
42725Incision and drainage of retropharyngeal abscess; external approach090External approach
42800Biopsy, oropharynx000Oropharyngeal tissue biopsy
42808Excision or destruction of lesion of pharynx010Pharyngeal lesion
42809Removal of foreign body from pharynx000FB removal
42810Excision branchial cleft cyst or vestige, confined to skin and subcutaneous tissues090Superficial branchial cleft
42815Excision branchial cleft cyst, vestige, or fistula, extending beneath subcutaneous tissues and/or into pharynx090Deep branchial cleft
42820Tonsillectomy and adenoidectomy; younger than age 12090T&A, pediatric
42821Tonsillectomy and adenoidectomy; age 12 and over090T&A, adult
42830Adenoidectomy, primary; younger than age 12090Adenoids only, pediatric
42831Adenoidectomy, primary; age 12 and over090Adenoids only, adult
42835Adenoidectomy, secondary; younger than age 12090Revision adenoidectomy, pediatric
42836Adenoidectomy, secondary; age 12 and over090Revision adenoidectomy, adult
42870Excision or destruction of lingual tonsil, any method090Lingual tonsil — OSA/tongue base reduction
42890Limited pharyngectomy090Partial pharynx removal
42892Resection of lateral pharyngeal wall, direct090Lateral wall
42894Resection of pharyngeal wall, radical090Radical pharyngeal resection
42950Pharyngoplasty090Pharynx reconstruction
42953Pharyngoesophageal repair090Combined pharynx/esophagus
42960Control of nasopharyngeal hemorrhage; simple010Post-tonsillectomy bleed — simple
42961Control of nasopharyngeal hemorrhage; requiring hospitalization010Post-tonsillectomy bleed — admission
42962Control of nasopharyngeal hemorrhage; with secondary surgical intervention010Return to OR — modifier -78
42970Control of nasopharyngeal hemorrhage, posterior, with posterior nasal packs and/or cautery010Posterior hemorrhage control

Tonsils

Tonsillectomy Age-Based Code Selection:

AgeTonsillectomy OnlyTonsillectomy and Adenoidectomy
Under 124282542820
12 and over4282642821
CPTDescriptionGlobalNotes
42820Tonsillectomy and adenoidectomy; younger than age 12090Most commonly billed pediatric ENT procedure
42821Tonsillectomy and adenoidectomy; age 12 and over090Adult T&A
42825Tonsillectomy, primary or secondary; younger than age 12090Tonsils only, pediatric
42826Tonsillectomy, primary or secondary; age 12 and over090Tonsils only, adult
42830Adenoidectomy, primary; younger than age 12090Adenoids only, pediatric
42831Adenoidectomy, primary; age 12 and over090Adenoids only, adult
42870Excision or destruction of lingual tonsil090Tongue base — bundled with 42820/42826 in same session per CMS

Salivary Glands

CPTDescriptionGlobalNotes
42300Drainage of abscess; parotid, simple010Parotid abscess
42305Drainage of abscess; parotid, complicated090Complex parotid abscess
42310Drainage of abscess; submaxillary or sublingual, intraoral010Submandibular abscess, intraoral
42320Drainage of abscess; submaxillary, external010External submandibular
42340Drainage of abscess; parotid, external complicated090External complex parotid
42400Biopsy of salivary gland; needle, percutaneous000FNA or core biopsy
42405Biopsy of salivary gland; incisional010Open incisional biopsy
42408Excision of sublingual salivary cyst (ranula)090Ranula excision
42409Marsupialization of sublingual salivary cyst (ranula)090Ranula marsupialization
42410Excision of parotid tumor or parotid gland; lateral lobe, without nerve dissection090Superficial parotidectomy
42415Excision of parotid tumor or parotid gland; lateral lobe, with dissection and preservation of facial nerve090Superficial parotidectomy with facial nerve preservation
42420Excision of parotid tumor or parotid gland; total, with dissection and preservation of facial nerve090Total parotidectomy, nerve preservation
42425Excision of parotid tumor or parotid gland; total, en bloc removal with sacrifice of facial nerve090Total parotidectomy, nerve sacrifice
42426Excision of parotid tumor or parotid gland; total, with unilateral radical neck dissection090Total parotidectomy + RND
42440Excision of submandibular (submaxillary) gland090Submandibular gland excision
42450Excision of sublingual gland090Sublingual gland excision
42500Plastic repair of salivary duct, sialodochoplasty; primary or simple090Duct repair
42505Plastic repair of salivary duct; secondary or complicated090Complex duct repair
42507Parotid duct diversion, bilateral (Wilke procedure)090For sialorrhea — drooling
42508Parotid duct diversion, bilateral, with excision of one or both submandibular glands090Drooling surgery
42509Parotid duct diversion, bilateral, with relocation of submandibular ducts090Full diversion
42510Parotid duct diversion, bilateral, with relocation of submandibular ducts and excision of one or both glands090Complete diversion with excision
42550Injection procedure for sialography000Salivary duct contrast study
42600Closure of salivary fistula090Fistula repair
42650Dilation of salivary duct000Office dilation
42660Dilation and catheterization of salivary duct, with or without injection000Catheterization
42665Ligation of salivary duct; intraoral010Duct ligation
42699Unlisted procedure, salivary glands or ductsN/AUnlisted salivary

Mouth and Oral Cavity

CPTDescriptionGlobalNotes
40490Biopsy of lip000Lip lesion biopsy
40510Excision of lip; transverse wedge excision with primary closure090Wedge lip excision
40520Excision of lip; V-excision with primary direct linear closure090V-excision
40525Excision of lip; full thickness, reconstruction with local flap090Abbe flap, etc.
40530Excision of lip; full thickness, reconstruction with cross lip flap (Abbé-Estlander)090Cross lip flap
40700Plastic repair of cleft lip/nasal deformity; primary, partial or complete, unilateral090Unilateral cleft lip
40701Plastic repair of cleft lip/nasal deformity; primary bilateral, one stage090Bilateral cleft lip, one stage
40702Plastic repair of cleft lip/nasal deformity; primary bilateral, second stage090Bilateral cleft lip, stage 2
40720Plastic repair of cleft lip/nasal deformity; secondary, by recreation of defect and reclosure090Secondary revision
41000Intraoral incision and drainage of abscess, cyst, or hematoma of tongue010Tongue I&D
41005Intraoral incision and drainage of abscess, cyst, or hematoma; sublingual, superficial010Sublingual I&D
41010Incision of lingual frenum (frenotomy)000Tongue tie release
41115Excision of lingual frenum (frenectomy)010Tongue tie excision
41520Frenoplasty090Frenulum reconstruction

Head and Neck — Excision and Neck Dissection

Neck Dissection

CPTDescriptionGlobalNotes
38700Suprahyoid neck dissection090Level I only
38720Cervical lymphadenectomy (modified radical neck dissection)090Selective/modified radical neck dissection
38724Cervical lymphadenectomy (radical neck dissection)090Radical neck dissection — removes SCM, IJV, CN XI
38740Axillary lymphadenectomy; superficial090Superficial axillary LND
38745Axillary lymphadenectomy; complete090Complete axillary LND

Sentinel Lymph Node Biopsy

CPTDescriptionNotes
38500Biopsy or excision of lymph node(s); open, superficialOffice or OR lymph node excision
38505Biopsy or excision of lymph node(s); by needle, superficialFNA or core biopsy, lymph node
38510Biopsy or excision of lymph node(s); open, deep, cervical node(s)Deep cervical node
38525Biopsy or excision of lymph node(s); open, deep, axillary node(s)Deep axillary node
38792Injection procedure; radioactive tracer for identification of sentinel nodeLymphoscintigraphy injection
38900Intraoperative identification (including injection of dye) of sentinel lymph nodeGamma probe/blue dye — add-on

Thyroid and Parathyroid (often ENT-performed)

CPTDescriptionGlobalNotes
60100Biopsy thyroid, percutaneous core needle000Core biopsy — not FNA
60200Excision of cyst or adenoma of thyroid090Partial thyroid excision
60210Partial thyroid lobectomy, unilateral; without contralateral subtotal lobectomy090Partial lobectomy
60212Partial thyroid lobectomy, unilateral; with contralateral subtotal lobectomy090Bilateral partial
60220Total thyroid lobectomy, unilateral; without contralateral subtotal lobectomy090Hemithyroidectomy
60225Total thyroid lobectomy, unilateral; with contralateral subtotal lobectomy090Near-total thyroidectomy
60240Thyroidectomy, total or complete090Total thyroidectomy
60252Thyroidectomy, total or subtotal for malignancy; with limited neck dissection090Total + limited central neck
60254Thyroidectomy, total or subtotal for malignancy; with radical neck dissection090Total + radical neck
60260Thyroidectomy, removal of all remaining thyroid tissue after prior partial thyroidectomy090Completion thyroidectomy
60270Thyroidectomy, including substernal thyroid; sternal split or transthoracic approach090Substernal goiter
60271Thyroidectomy, including substernal thyroid; cervical approach090Substernal via cervical
60500Parathyroidectomy or exploration of parathyroid gland(s)090Parathyroid exploration
60502Parathyroidectomy or exploration; re-exploration090Revision parathyroid
60505Parathyroidectomy or exploration; with mediastinal exploration, sternal split or transthoracic approach090Mediastinal parathyroid
60512Parathyroid autotransplantation090Add-on — parathyroid reimplantation
60520Thymectomy; partial or total; transcervical approach090Cervical thymectomy
60521Thymectomy; partial or total; sternal split approach090Sternal approach
60522Thymectomy; partial or total; combined transcervical and sternal approach090Combined approach

MS-DRG Reference

MDC 03 — Diseases and Disorders of the Ear, Nose, Mouth and Throat

DRGDescriptionWhen
129Major Head and Neck Procedures with MCCMajor resection, LND, laryngectomy with MCC
130Major Head and Neck Procedures with CCMajor procedures with CC
131Major Head and Neck Procedures without CC/MCCMajor procedures, no CC/MCC
132Laryngeal and Other ENT OR Procedures with MCCENT OR procedures, MCC
133Laryngeal and Other ENT OR Procedures with CCENT OR procedures, CC
134Laryngeal and Other ENT OR Procedures without CC/MCCENT OR procedures, no CC/MCC
135Sinus and Mastoid Procedures with MCCSinus/mastoid surgery, MCC
136Sinus and Mastoid Procedures with CCSinus/mastoid surgery, CC
137Sinus and Mastoid Procedures without CC/MCCSinus/mastoid surgery, no CC/MCC
138Mouth Procedures with MCCOral procedures, MCC
139Mouth Procedures with CCOral procedures, CC
140Mouth Procedures without CC/MCCOral, no CC/MCC
141Salivary Gland ProceduresSalivary gland surgery
185Dental and Oral Disease with MCCMDC 03 medical, MCC
186Dental and Oral Disease with CCMDC 03 medical, CC
187Dental and Oral Disease without CC/MCCMDC 03 medical, no CC/MCC

Global Period Quick Reference

Global PeriodExamples in ENT
000Flexible laryngoscopy (31575), cerumen removal (69210), diagnostic endoscopy (31231), biopsy (30100)
010Tube insertion (69436), simple tympanoplasty (69610), turbinate reduction (30130/30140), epistaxis (30901/30905)
090Tonsillectomy (42820/42826), septoplasty (30520), FESS (31254-31298), laryngectomy (31360/31365), parotidectomy (42415), tympanoplasty (69631-69646)
XXXDiagnostic procedures only; no global

Common ICD-10-CM Diagnoses — ENT

Ear

ICD-10-CMDescription
H61.23Impacted cerumen, bilateral
H66.003Acute suppurative otitis media, bilateral
H65.23Chronic serous otitis media, bilateral
H69.83Other specified disorders of Eustachian tube, bilateral
H72.01Central perforation of tympanic membrane, right
H74.31Acquired abnormality of ossicular chain, right
H80.03Cochlear otosclerosis, bilateral
H91.03Ototoxic hearing loss, bilateral
H90.3Sensorineural hearing loss, bilateral
H83.01Labyrinthitis, right ear
H81.01Meniere’s disease, right ear

Nose and Sinuses

ICD-10-CMDescription
J34.2Deviated nasal septum
J34.3Hypertrophy of nasal turbinates
J32.0Chronic maxillary sinusitis
J32.2Chronic ethmoidal sinusitis
J32.3Chronic sphenoidal sinusitis
J32.1Chronic frontal sinusitis
J32.4Chronic pansinusitis
J33.0Polyp of nasal cavity
J33.8Other polyp of sinus
R04.0Epistaxis
J30.1Allergic rhinitis due to pollen
J30.9Allergic rhinitis, unspecified

Throat and Tonsils

ICD-10-CMDescription
J35.01Chronic tonsillitis
J35.03Chronic tonsillitis and adenoiditis
J36Peritonsillar abscess
J35.1Hypertrophy of tonsils
J35.2Hypertrophy of adenoids
J35.3Hypertrophy of tonsils with hypertrophy of adenoids
G47.33Obstructive sleep apnea, pediatric
G47.33Obstructive sleep apnea

Larynx and Voice

ICD-10-CMDescription
J38.0Paralysis of vocal cords and larynx
J38.01Paralysis of vocal cords and larynx, unilateral
J38.02Paralysis of vocal cords and larynx, bilateral
J38.1Polyp of vocal cord and larynx
J38.2Nodules of vocal cords
J38.3Other diseases of vocal cords
J38.4Edema of larynx
J38.5Laryngeal spasm
J38.6Stenosis of larynx
J38.7Other diseases of larynx
C32.0Malignant neoplasm of glottis
C32.1Malignant neoplasm of supraglottis

Head and Neck Malignancy

ICD-10-CMDescription
C09.9Malignant neoplasm of tonsil, unspecified
C10.9Malignant neoplasm of oropharynx, unspecified
C11.9Malignant neoplasm of nasopharynx, unspecified
C13.9Malignant neoplasm of hypopharynx, unspecified
C32.0Malignant neoplasm of glottis
C32.1Malignant neoplasm of supraglottis
C73Malignant neoplasm of thyroid gland
C77.0Secondary malignant neoplasm of lymph nodes of head, face and neck
D11.0Benign neoplasm of parotid gland

Modifier Quick Reference — ENT

ModifierENT Use Case
-25Same-day E/M with procedure — cerumen removal + ETD management; endoscopy + new patient eval
-50Bilateral procedure — bilateral tubes, bilateral FESS, bilateral turbinate reduction
-51Multiple procedures same session — septoplasty + turbinates; FESS + septoplasty
-52Reduced services — unilateral when bilateral planned; incomplete FESS
-53Discontinued procedure — patient safety reason; unable to complete
-58Staged procedure — planned second-stage sinus surgery
-59Distinct procedural service — unbundle separately payable procedures
-62Co-surgeons — skull base; free flap reconstruction requiring two primaries
-78Unplanned return to OR in global period — post-tonsillectomy hemorrhage
-79Unrelated procedure in global period
-LT/-RTLaterality — required for all unilateral ear, nasal, sinus, and neck procedures
-22Significantly increased complexity — hostile anatomy, revision surgery, extended LND
-XUUnusual non-overlapping service — alternative to -59

Individual Code Notes in This Vault

CPTDescriptionNote Status
42820Tonsillectomy and adenoidectomy, under 12(create note)
42826Tonsillectomy, age 12 and over(create note)
30520Septoplasty✅
30140Submucous resection inferior turbinate(create note)
31267FESS maxillary antrostomy with tissue removal(create note)
31255FESS total ethmoidectomy(create note)
69436Tympanostomy, general anesthesia(create note)
69631Tympanoplasty with ossicular chain reconstruction(create note)
31360Total laryngectomy(create note)
42415Superficial parotidectomy with facial nerve preservation(create note)
60240Total thyroidectomy(create note)
38720Cervical lymphadenectomy(create note)
30905Posterior epistaxis control✅
69210Removal of impacted cerumen(create note)

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