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Official Description

Control oropharyngeal hemorrhage, primary or secondary (eg, post-tonsillectomy); with secondary surgical intervention

© Copyright 2025 American Medical Association. All rights reserved.

Common Language Description

The CPT® Code 42962 pertains to the medical procedure involved in controlling oropharyngeal hemorrhage, which can be classified as either primary or secondary. Primary oropharyngeal hemorrhage occurs independently of any surgical intervention, while secondary oropharyngeal hemorrhage is a complication that arises following surgical procedures, such as a tonsillectomy. This code specifically addresses cases where the hemorrhage necessitates a secondary surgical intervention to effectively manage the bleeding. The procedure involves a thorough examination of the throat to identify the source of the bleeding. In instances where fresh blood clots are present, these are carefully removed to facilitate access to the bleeding sites. The physician then employs techniques such as cauterization or suture tying to control the bleeding. If these initial measures do not suffice and the bleeding persists, further intervention may be required, including the application of suture ligatures to secure the bleeding sites. This comprehensive approach ensures that the hemorrhage is effectively managed, minimizing the risk of complications and promoting patient safety.

© Copyright 2025 Coding Ahead. All rights reserved.

1. Indications

The procedure associated with CPT® Code 42962 is indicated for the management of oropharyngeal hemorrhage, which may be classified as either primary or secondary. The specific indications for this procedure include:

  • Primary Oropharyngeal Hemorrhage - This type of hemorrhage occurs without any preceding surgical intervention and may require surgical control if the bleeding is significant or persistent.
  • Secondary Oropharyngeal Hemorrhage - This refers to bleeding that occurs as a complication following surgical procedures, such as tonsillectomy, necessitating further surgical intervention to control the bleeding effectively.

2. Procedure

The procedure for CPT® Code 42962 involves several critical steps to ensure effective control of oropharyngeal hemorrhage. The steps are as follows:

  • Step 1: Examination of the Throat - The physician begins by conducting a thorough examination of the throat to assess the extent of the hemorrhage and to identify the specific sites of bleeding. This initial assessment is crucial for determining the appropriate course of action.
  • Step 2: Removal of Fresh Blood Clots - If fresh blood clots are present, the physician carefully removes them to gain clear access to the bleeding sites. This step is essential for accurately identifying the source of the hemorrhage and for effective treatment.
  • Step 3: Control of Bleeding - Once the bleeding sites are identified, the physician employs various techniques to control the hemorrhage. This may include cauterization, which uses heat to seal the blood vessels, or suture tying to physically secure the bleeding sites. These methods are aimed at stopping the bleeding and preventing further complications.
  • Step 4: Suture Ligature if Necessary - In cases where the bleeding continues despite initial control measures, the physician may need to apply suture ligatures to the bleeding sites. This step is critical for ensuring that the hemorrhage is fully managed and that the patient is stabilized.

3. Post-Procedure

After the procedure associated with CPT® Code 42962, the patient may require monitoring to ensure that the bleeding has been successfully controlled. Post-procedure care typically includes observation for any signs of recurrent bleeding, as well as the management of pain and discomfort. The physician may provide specific instructions regarding dietary restrictions, activity limitations, and follow-up appointments to assess recovery. It is essential for the patient to adhere to these guidelines to promote healing and prevent complications.

Short Descr CONTROL THROAT BLEEDING
Medium Descr CTRL OROPHARYNGEAL HEMORRHAGE W/SEC SURG IVNTJ
Long Descr Control oropharyngeal hemorrhage, primary or secondary (eg, post-tonsillectomy); with secondary surgical intervention
Status Code Active Code
Global Days 090 - Major Surgery
PC/TC Indicator (26, TC) 0 - Physician Service Code
Multiple Procedures (51) 2 - Standard payment adjustment rules for multiple procedures apply.
Bilateral Surgery (50) 0 - 150% payment adjustment for bilateral procedures does NOT apply.
Physician Supervisions 09 - Concept does not apply.
Assistant Surgeon (80, 82) 1 - Statutory payment restriction for assistants at surgery applies to this procedure...
Co-Surgeons (62) 0 - Co-surgeons not permitted for this procedure.
Team Surgery (66) 0 - Team surgeons not permitted for this procedure.
Diagnostic Imaging Family 99 - Concept Does Not Apply
APC Status Indicator Hospital Part B services paid through a comprehensive APC
ASC Payment Indicator Surgical procedure on ASC list in CY 2007; payment based on OPPS relative payment weight.
Type of Service (TOS) 2 - Surgery
Berenson-Eggers TOS (BETOS) P1G - Major procedure - Other
MUE 1
CCS Clinical Classification 33 - Other OR therapeutic procedures on nose, mouth and pharynx
51 Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d).
53 Discontinued procedure: under certain circumstances, the physician or other qualified health care professional may elect to terminate a surgical or diagnostic procedure. due to extenuating circumstances or those that threaten the well being of the patient, it may be necessary to indicate that a surgical or diagnostic procedure was started but discontinued. this circumstance may be reported by adding modifier 53 to the code reported by the individual for the discontinued procedure. note: this modifier is not used to report the elective cancellation of a procedure prior to the patient's anesthesia induction and/or surgical preparation in the operating suite. for outpatient hospital/ambulatory surgery center (asc) reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use).
58 Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78.
59 Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25.
78 Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, see modifier 76.)
79 Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.)
AS Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery
CR Catastrophe/disaster related
GC This service has been performed in part by a resident under the direction of a teaching physician
RT Right side (used to identify procedures performed on the right side of the body)
XU Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service
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