CPT for ENT: Neck Dissection and Laryngoscopy on the Same Date of Service

As a result of the advocacy of the Academy, the National Correct Coding Initiative (NCCI) will delete the current bundling edit for the neck dissection CPT codes (38720-Cervical lymphadenectomy (complete) and 38724 – Cervical lymphadenectomy (modified radical neck dissection) when performed on the same patient and the same date of service with CPT code 31525 – Laryngoscopy direct, with or without tracheoscopy; for aspiration; diagnostic, except newborn. The NCCI will implement this change in version 15.2 on July 1, 2009. Previously, physicians who performed both procedures on the same date could override the bundling edit by using a relevant modifier.

The Academy decided to pursue the deletion of the bundling edits for these services because no cogent logic existed for them. Our rationale was that the laryngoscopy is completely separate from, and independent of, both types of neck dissection. The same surgeon may perform both services on the same date but, more frequently, they would not.

You will want to provide clear documentation explaining the medical necessity of performing the neck dissection and laryngoscopy on the same date.

Reviewed October 2023
Published July 2009

IMPORTANT DISCLAIMER NOTICE

CPT FOR ENT ARTICLES ARE A COLLABORATIVE EFFORT BETWEEN THE ACADEMY’S TEAM OF CPT ADVISORS, MEMBERS OF THE PHYSICIAN PAYMENT POLICY (3P) WORKGROUP, AND HEALTH POLICY STAFF. ARTICLES ARE DEVELOPED TO ADDRESS COMMON CODING QUESTIONS RECEIVED BY THE HEALTH POLICY TEAM, AS WELL AS TO CLARIFY CODING CHANGES AND CORRECT CODING PRINCIPLES FOR FREQUENTLY REPORTED ENT PROCEDURES. THESE ARTICLES ARE NOT INTENDED AS LEGAL, MEDICAL, OR BUSINESS ADVICE AND ARE NOT A GUARANTEE OF REIMBURSEMENT. THE INFORMATION IS ALSO NOT MEANT TO SERVE AS THE DEFINITIVE OR SOLE AUTHORITY ON BILLING AND CODING ISSUES. THE APPLICABILITY OF AAO-HNS BILLING AND CODING GUIDANCE FOR A PARTICULAR PROCEDURE, MUST BE DETERMINED BY THE RESPONSIBLE PHYSICIAN IN LIGHT OF ALL THE CIRCUMSTANCES PRESENTED BY THE INDIVIDUAL PATIENT. YOU SHOULD CONSULT WITH YOUR OWN ADVISORS AS WELL AS MEDICARE OR PRIVATE CARRIERS IN MAKING ANY DECISIONS ABOUT HOW TO BILL AND CODE PARTICULAR SERVICES OR PROCEDURES.